Secure Portal Enhancements: COB Claims and Claim Adjustments

Posted 25 Abril 2012 by aborgmeyer & filed under newsroom, Provider News.

Providers now have the option to submit COB claims and Correct Claims through the Secure Web Portal. Click here to view the EDI Mapping Guide.

 

COB CLAIMS

For both Professional and Institutional claims submissions on the Secure web portal, providers have an additional question asking “Does the member have additional coverage?”. If “No” is selected, the provider can continue with the claim as normal. If ”Yes” is selected, the Coordination of Benefits section will be available at the next step of the claims submission.

Carrier type will be either “Medicare” or “Commercial” and there is also a required field to indicate if this is the “Primary” or “Secondary” Carrier. The Carrier Payment section contains fields for the Amount Allowed, Deductible, Copay, Co-Insurance, and Amount Paid. The Denied Reason section allows providers to select the reason along with the dollar amount to deny for each reason.

CORRECT CLAIM

From the Check Claims Status screen, search for a claim.

 

From the results, click on the Claim No. of the claim to be corrected.

To correct this claim, click on “Correct Claim” link on the upper left.