Rejection: Payer Specific Edit: Medi-cal should not be billed first when patient has Medicare. Bill Medicare first. If Medicare paid $0, then bill a Primary claim with Medi-cal as Primary, do not list Medicare. (FE418)
What happened: Medicare was listed as the 'other' payer in box 9d OR a secondary claim was sent where Medicare was the primary and paid zero (see attached picture below).
Resolution: Medi-Cal is always the secondary payer when a patient also has Medicare. For that reason, a primary claim cannot have Medicare listed as the 'other' payer in box 9d. Also, per Medi-Cal, if Medicare was billed first and paid nothing, instead of a secondary claim being billed to Medi-Cal, a primary claim needs to be billed to Medi-Cal and Medicare should not be listed on the claim anywhere.
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