When you are new to a system it is very tough to wear the hat of your predecessor and win hearts. It is challenging to work with an EMR like eClinicalWorks..Read more..

1. How to submit Medicaid/Medicare secondary
claims electronically using eClinicalWorks!

3. It has never been a cakewalk working with an
EHR. You know how tough it can be, if you don’t
have an eClinicalWorks expert to help you with
billing needs. What do you do when you are not
aware of a certain feature or a procedure?

4. We reached out to some organizations to know how what they
did to find a solution to their problem.
Here are the top answers we would like to list down:
 Raised the ticket with eClinicalWorks EHR but yet to receive a
response
 Called the eClinicalWorks EHR support and was put on hold for
thirty minutes.
 Thought of navigating to the eClinicalWorks EMR’s guide but either
didn’t have time OR didn’t know the correct path.
 Tried to use search engines but couldn’t find the correct link.
 Called the local eClinicalWorks experts but asked to pay to get a
solution.

5. We have received inquiries on how to bill medicaid/medicare
secondary claims using eClinicalworks EHR?
 There have been many cases where organizations have
reported that they suffer clearing house rejections due to
secondary claims.
 What do you need to know on submitting secondary
claims?
 Do you change your clearing house if you face multiple
rejections?
 What if, you want to know a list of services provided that
have a payer as secondary?
 How do you find it without using a reporting tool?

6. You got frustrated with your clearing house and
decided to send the paper claims and your secondary
claim was denied. There could be other reasons for
claim denials from the payer but, you might have
missed to send a COB (Co-ordination of benefits) OR
for the other reasons.

7. Your secondary claims were rejected and a kind of an
error message from the clearing house which states the
secondary identifier qualifier must be a valid one. You
called your clearing house, EMR and payer but didn’t
get to hear anything.

8. Suppose Medicare/Medicaid is a secondary insurance
and you used a wrong code. Clearing house denies
your claim. It is certainly a 5010 issue. But insurance
eligibility verification is equally important.

9. When do you know Medicare is secondary?
These Type codes will help you know if your patient has a
Medicare Secondary:
 Type 12: An aged employee or spouse who’s employer has a
group health plan of greater than twenty employees.
 Type 13: A patient has coverage under an End State Renal
Disease coordination period for the first thirty months.
 Type 14 or 47: Patient has a no fault plan, includes liability or
auto claims

10.  Type 15: Patient has a worker’s compensation claim
 Type 42: One who is under a VA (veteran administration)
plan but has been seen in VA facility or a VA doctor
 Type 43: Patient is disabled and the employer group plan
has more than 100 employees

11. Before you proceed with billing secondary claims,
 Make sure have the ANSI code for each patient( Twelve
codes to choose from and don’t expect the patients to know
that)
 Don’t forget to check if the CAS adjustment code loaded
into each claim line and each of the claim line is completely
posted.
If you wish to differentiate between the primary and
secondary claims, you can sign up with an MSP account

12. And most important information which is usually
missed out:
 Check the EOB date and the check date in tab where you
need to feed the check amount.
 Don’t miss to check if the Group number is loaded in the
primary payer.

13. What if I have an eCW expert to walk you through six simple
steps to submit secondary claims using eClinicalWorks EHR?
Let’s learn the step by step procedure for billing secondary
claims through eClinicalWorks in our next article.

14. Need a helping hand? Call us @ 1-609-807-8008
OR
Mail us: support@thepracticebridge.com