Claim Rejections

Medicaid TX TMHP1 - CLIENT HAS OTHER INSURANCE

Rejection: Acknowledgement/Returned as unprocessable claim | CLAIM INDICATES CLIENT HAS OTHER INSURANCE. ALL OR PART OF THE REQUIRED INFORMATION IS MISSING. SEE PROVIDER MANUAL FOR REQUIRED OTHER INSURANCE INFORMATION. | PERFORMING PROVIDER NUMBER NOT IDENTIFIED

What happened: A secondary claim was sent where the primary payer was not Medicare (see attached picture below).

Resolution: This payer only accpets secondary claims when the primary payer is Medicare. If the primary was any other payer, need to send by paper.

primary payer name (secondary claims).jpg