Overview
Members can indicate the Carrier Code for each Primary insurance included on electronic and paper claims when Medicaid is billed as the secondary payer. To reduce claim rejections, the automated claim validation process will prevent submitting claims to Medicaid if a Carrier Code isn’t selected. Additionally, the Carrier Codes will be added to the CMS-1500 claims without needing to be manually entered.
The Carrier Code is included on the CMS-1500 and EDI files as follows:
- On the CMS-1500
- A new Carrier Code field value will display in box 9d
- On the 837P
- A new Carrier Code field value will display
- Loop 2330B NM108 = PI
- Loop 2330B NM109 = Carrier Code value
- Loop 2430 SVD01 = Carrier Code value
- A new Carrier Code field value will display
- For Medicaid Illinois (IL261)
- Add Loop 2330B REF segment
- REF01 = 2U
- REF02 = Carrier Code value
- Add Loop 2330B REF segment
States that Require a Carrier Code
- Arkansas
- Connecticut
- Illinois
- Louisiana
- Massachusetts
- New Hampshire
- Pennsylvania
- Rhode Island
- South Carolina
- Vermont
Please refer to the links above to determine which Carrier Codes should be entered for your primary insurances.
Add a Carrier Code
- Navigate to the Billing menu, then select Insurance List.
- Select the Info & Settings link on the Primary insurance.
- On the General tab, enter the Carrier Code.
Fix a Carrier Code Error
If the claim does not pass the Carrier Code validation check, the following error will display:
- Click on the edit pencil icon to open the primary insurance settings.
- Enter the Carrier Code into the appropriate field.
- Click Save Changes.
- Close the window.
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