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Wiki Medicare Primary-Medicaid Secondary Crossovers

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melheffley

Networker
Messages
45
Location
Caledonia, OH
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Does anyone from Ohio have a solution to get Medicaid crossover claims paid when Medicare Part C applies to the deductible? When a Medicare Part C processes a claim and applies the full allowed amount to the deductible, we cannot get Ohio Medicaid to pay the balance. The claim will deny for reason code "23" other insurance payment. Sometimes we get lucky and will receive payment, but the majority we do not. We have not been successful in getting a straight answer from Provider Network Management (PNM). I have opened multiple cases with no resolution. Just looking to see if anyone else has possibly cracked the secret code! Thank you in advance!!
 
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