Medicare is Secondary Payer - JF Part B
Medicare is Secondary Payer
| CARC/RARC | Description |
|---|---|
| CO-16 | Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. |
| MA04 | Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible. |
Common Reasons for Message
- Incorrect primary payer type was submitted on an electronic claim
- A claim has been submitted as Medicare secondary and national file shows Medicare is primary
Next Step
- Verify whether Medicare is primary or secondary
- Claim may be resubmitted with corrected information, or the MSP type can be corrected via a self-service reopening:
- If Medicare is secondary, verify correct primary insurance type was submitted in loop 2000B SBR02
- If Medicare is primary, verify no MSP information was billed on claim
Claim Submission Tips
- Prior to submitting claim(s), verify patients' eligibility via Interactive Voice Response (IVR) or the Noridian Medicare Portal
- If there is a problem with file, patient may contact Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 to make necessary corrections
- For electronic claims, verify that all necessary primary information is correctly submitted on claim
Last Updated Dec 09 , 2023
