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April 2, 2018

BCBSKS Secondary to Medicare Primary Claims Edit

Within the next 60 days, EDI front end editing will be strengthened for BCBSKS Secondary to Medicare Primary Claims.

When submitting a BCBSKS Secondary to Medicare Primary claim the MOA
(Medicare Outpatient Adjudication) MIA (Medicare Inpatient Adjudication) information from the Medicare Remittance Advice must be submitted for accurate processing.

In the 837 Professional transaction, the MOA is submitted in loop and segment
2320 MOA.

In the 837 Institutional transaction, the MIA is submitted in loop and segment
2320 MIA.

In the 837 Institutional transaction, the MOA is submitted in the loop and segment 2320 MOA.

 

 

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