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eClaims - Common Rejections - Plan Type (Medicare B)

Other Payer Plan Type (Medicare)
Rejection Message:

  • OTHER PAYER CLAIM FILING INDICATOR CODE IS INVALID. CANNOT = MEDICARE
  • OTHER PAYER INSURANCE TYPE CODE IS REQUIRED WHEN PAYER IS MEDICARE (NOT PRIMARY)

This rejection is stating that a claim cannot be sent with more than one Medicare B payer. Only one payer on a claim can have a plan type labeled as 'Medicare B' per CMS billing guidelines. If any other payer with a 'Medicare B' plan type is listed on a claim it will trigger a rejection. To resolve this, first check the insurance references for the patient to find out what plan type is currently set. Medicare B should only ever be set for Medicare payers. Unless specifically required by the payer, Supplemental Medicare plans should be set to something other than 'Medicare B'; usually 'Commercial insurance' or 'BCBS', depending on the the plan. This also applies to other Medicare plan types, therefore you cannot set the plan type to 'Other Federal Program' as this is for Medicare D.
Note: The plan type dropdown is located in two areas of the insurance reference. The main location in under the 'Claims' tab. There is also a plan specific plan type dropdown under Plans > Demographics, should the patient have a plan set on their account.

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