[MT-L] Custom Claim Checks for Claim Queue Delay

[Popelka, Kelly - CRH]

We are Magic 5.64 using Print Image (UB04) claims.  Does anyone have or have need for a claim check that will hold the claim a specified # of days?  We have 2 scenarios that require this type of check:

 

1)      We have to submit Medicaid secondary claims within 180 days to avoid timely filing denials, in the event Primary claim hasn’t been processed by payer by then.  We want an automated way to drop the Medicaid 2ndry claim after 150 days when Primary hasn’t paid.

2)      For all Secondary claims,  we want to hold them for 2 days after Primary payment has posted and balance drops b/c the Primary EOB hasn’t been scanned and attached to the account yet.

 

Thanks for any advice,

Kelly

_________________________________________________________

Kelly Popelka

Manager, IT Business Informatics

 

Chandler Regional Medical Center | Mercy Gilbert Medical Center

Dignity Health Members

(623) 521-2815 (Office/Mobile)

(602) 294-5413 (Fax)

 

Kelly....@DignityHealth.org

 

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[Julia Carter]

Hi, Kelly,

 

For #1, you could use a reimbursement management rule that automatically moves the money when Medicaid is secondary and the primary hasn’t paid/denied within X number of days.  You might also explore the Auto Rebill Delay setting in the Claims dictionary.

 

For #2, I think Meditech could probably create a claim check that looks at the posting date of the payment and then adds two days to the claim generation.  My experience with the BAR/CL programmers is that they can work a lot of MAGIC, even in C/S and 6.0.  J  This is an interesting concept and I’d like to know the results.

 

HTH

 

Thanks!

 

Julia

Jacobus Consulting

229-891-6668

[Popelka, Kelly - CRH]

Hi Julia – I wanted to follow back up with you on this.  We did get the #2 check (zPRI INS 2DY), and it’s working well! 

 

They created a check for our #1 scenario for Medicaid 2ndry, but it’s not working as expected, so we’re still testing.  I’m hopeful Meditech will be able to get it right : )

 

Thanks,