Denial code MA68

Remark code MA68 indicates a claim wasn't crossed over due to incomplete secondary insurance info; providers must ensure data accuracy for proper routing.

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What is Denial Code MA68

Remark code MA68 is an alert indicating that the claim was not automatically forwarded to the secondary insurance because the secondary insurance information provided on the claim was incomplete. To address this, the healthcare provider must ensure that complete secondary insurance details are submitted or utilize the PLANID of the insurer to ensure the claim is routed correctly and promptly.

Common Causes of RARC MA68

Common causes of code MA68 are:

1. Missing secondary insurance information: Essential details such as policy numbers, group numbers, or insurance company contact information are not provided on the claim.

2. Incorrect secondary insurance information: The claim contains inaccurate or outdated information regarding the secondary insurer.

3. Incomplete patient demographics: Patient-related information necessary for the secondary insurer to process the claim is missing or incomplete.

4. Lack of coordination of benefits (COB): The claim does not properly indicate the order of responsibility between primary and secondary insurers.

5. Incorrect use of modifiers or procedure codes: The claim may have been flagged due to improper coding that affects secondary insurance processing.

6. Failure to include primary insurance payment details: The claim lacks evidence of the primary insurance's payment, adjustment, or denial, which is necessary for the secondary insurer to determine their liability.

7. Technical errors in electronic claim submission: Electronic Data Interchange (EDI) issues or incorrect formatting can prevent the crossover of the claim to the secondary insurer.

8. Plan identification issues: The claim does not include the correct PLANID or uses an invalid identifier for the secondary insurer, leading to routing errors.

Ways to Mitigate Denial Code MA68

Ways to mitigate code MA68 include ensuring that all secondary insurance information is thoroughly reviewed and complete before submitting the claim. This includes verifying the accuracy of the patient's policy number, group number, and the insurance company's name and address. Additionally, double-checking that the PLANID is correctly entered can help assure the correct and timely routing of the claim. Implementing a pre-claim submission process that includes a checklist for secondary insurance details can also help prevent this code from occurring. Regular training for billing staff on the importance of complete insurance information and the use of updated insurance verification tools can further reduce the likelihood of receiving code MA68.

How to Address Denial Code MA68

The steps to address code MA68 involve a thorough review of the claim to identify any missing or incomplete secondary insurance information. Ensure that all required fields are accurately filled out, including the patient's policy number, group number, and the insurance payer's address. Double-check the PLANID of the insurer to confirm it is correct and corresponds with the payer's records. Once the missing information is provided or any inaccuracies are corrected, resubmit the claim to the secondary insurer for processing. It's also advisable to update your billing system to prevent similar issues on future claims.

CARCs Associated to RARC MA68

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