Reason Code 34538 - JE Part A
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.
Last Updated Tue, 10 Nov 2020 17:37:23 +0000