Reason Code 34538

Reason Code Narrative

CLAIM SUBMITTED AS MEDICARE PRIMARY AND A POSITIVE WORKING ELDERLY RECORD EXISTS AT CWF. THE CONTRACTOR ID IS EQUAL TO ‘11121.'  THE CLAIM SHOULD BE BILLED TO THE EMPLOYER GROUP HEALTH PLAN.

Common Reason Code Errors

  • Claim was submitted as Medicare primary, however CWF shows an open working aged record.

Common Reason Code Corrections

  • Collect primary insurer information from beneficiary and resubmit claim with correct primary payer and Medicare as secondary information.
  • If beneficiary no longer has other primary insurance, contact Benefits Coordination and Recovery Center (BCRC) to update working aged file.

Resources

 

Last Updated Tue, 10 Nov 2020 17:37:23 +0000