Over the last couple of weeks we've been getting calls about BCBS Michigan edits regarding Medicare, RR Medicare, DMERC etc.
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Per BCBSM:
"Effective 9/28/2012, Medicare implemented new front-end edits for
all Medicare Part B and Medicare DMERC professional claims. The edits are triggered by Medicare for claims reporting a Group Name in
Loop 2000B SBR04. Edits are returned on 277CAW and 277CAM reports and 277CA transactions:
A8 663 IL Entity's Group Name
A8 732 IL Information submitted inconsistent with billing guidelines"
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Michigan THOMAS clients must take out what they have in plan name and group name for MR (Medicare) and RRMR (Rail Road Medicare) policies only, to comply with the Medicare guidelines.
If you have additional questions, or have done this and are still receiving these edits, please call support.
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