Before submitting your secondary claims, confirm the following or errors may be generated.
Payer Library (Step 1)
• In the Payer Library, if the Secondary payer is Medicare, confirm that Medicare secondary ‘Ins.Type Code’ is selected.
Patient Information screen (Step 2)
• Secondary Insured’s Name, DOB and Gender are entered.
• If Medicare/Medicaid Other Insured Policy or Group number field is blank.
• Secondary (and Primary) Insurance with Payer ID is entered.
• SSN, Patient Member ID and Additional ID number are blank. See Additional Information.
• Secondary/Other Insured’s ID# is entered in the ‘Insured’s ID’ field.
• Secondary subscriber ‘Patient Rel to Insured’ is selected.
Claim screen (Step 3)
• Confirm Payment information entered matches the EOB.
• Confirm each service line has an Insurance payment entered even if it is a $0.00.
• Line Item payments and/or adjustments with a date have been entered.
• Confirm ‘Bill To:’ has been set to ‘Secondary Insurance’.
• In the ‘Claim Grid’ confirm the ‘Ignore Applied Amount’ box is unchecked.
Your claim is now ready for submission or printing.
2320 COB CLAIM BALANCING FAILED. (Balancing error) Step 3
• All service lines did not have payment entered and/or payment amounts were incorrect.
OTHER SUBSCRIBER INFORMATION IS MISSING OR INVALID
• Patient Information screen – Confirm ‘Secondary Insured’s’ information is entered. Step 2
• Patient Information – Confirm BOTH insurances have a Payer ID. Step 1. Also make sure the ‘Insured’s ID’ field has the secondary ID. Step 2
OTHER PAYER SUBSCRIBER PRIMARY IDENTIFICATION NUMBER IS MISSING OR INVALID
• Patient Information screen – Confirm ‘Secondary Insured’s ID’ field has secondary subscriber ID entered. Step 2
• Patient Information screen – Confirm ‘Insured’s Policy or Group’ number field is blank. Step 2
INSURANCE TYPE CODE MISSING OR INVALID
• Payer Library – In the ‘Insurance Type’ drop-down box choose one of the numbers for Medicare secondary Insurance ‘Type Code’. Step 1
INSURANCE TYPE CODE IS MISSING OR INVALID. (Bad Data: MB)
• Payer Library – Usually this is for a Medicare claim when MB is indicated as the bad data. In the ‘Ins Type’ drop-down box choose one of the numbers for ‘Medicare Secondary Claims’. Step 1
Use this sample of an analyzed Secondary claim to confirm data. See sample below.
How to Analyze a Claim
1. Go to ‘Electronic Billing’.
2. Select ‘Send Claims’.
3. Select by checking the claim to be analyzed.
4. Use the Check for Errors drop-down box and choose ‘Detailed Report’.
5. Compare to sample below. (Sample is for a Medicare secondary claim your claim may include different data depending on your payer.)