Reason Code 34540

Reason Code Narrative

CLAIM SUBMITTED AS MEDICARE PRIMARY AND A POSITIVE DISABILITY 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 disabled 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 disabled file.

Resources

 

Last Updated Mon, 09 Mar 2020 10:47:23 +0000