Ah, Medicare.
For those who bill Medicare, you know how important it is to make sure all your i’s are dotted and t’s are crossed.
In the rare case that Medicare is the secondary payer on a claim, you will be asked to provide a Medicare Type Code on the claim submission. There isn’t a spot in Jane to enter a Medicare Type Code, so you’ll want to submit the secondary claim outside of Jane in order to enter the code, and then manually change the status of the claim in Jane. We’ll go through these steps below.
For those who use the ClaimMD Integration, check out their guide: How do I handle Secondary Claims?.
Now let’s look at how this is recorded in Jane:
-
Before submitting the secondary claim through your clearinghouse, make sure the primary claim is recorded in Jane.
-
Once the primary claim has been recorded, Jane will automatically move the Medicare secondary claim to the Unsubmitted folder.
-
Do not submit the secondary claim through Jane. Instead, log into your Clearinghouse portal and submit the secondary claim to the secondary payer directly through your clearinghouse. You can include the Medicare Type Code on their submission form.
-
Once the claim is submitted, change the status of the secondary claim to Submitted in Jane. To do this, head to Billing > Unsubmitted and locate the claim by filtering or searching for the patient’s name, then click View to the right of the claim.
Click the down arrow next to Claim and choose Mark as Submitted from the menu.
All done!
With the ClaimMD Integration, the claim response will flow directly into Jane as usual and you will be able to reconcile it from the remittance as normal.
For other clearinghouses, you can download the ERA (Claim Response) and upload it into Jane as normal to reconcile the secondary claim response.
You can learn more about posting electronic remittances in our guide Posting Insurer Payments With ERAs.
If you receive a paper EOB from the insurer, follow the steps in our handy guide Posting Insurer Payments With Paper EOBs.
Questions? Click the Need Help? button in your Jane admin or reach out to our helpful support team.