Electronic Claims

[parksjdp]

For those that use Tesia

We are having some problems with our Medicaid insurance claims. They say that they have not gotten a claim from us in over 2 months. We then contacted OD and they said that we have the acknowlegments from Tesia so it must be something on Tesia or Medicaid's end. How do these acknowledements work? Under the send claims screen we can see that the Medicaid claims show accepted in the AckCode Column. Who says they are accepted? Who is accepting them? If Tesia says they show them as being sent, but Medicaid says they have not rec'd them, what do I do? Tesia is not helping us on there end. Shoud we consider another clearing house?

[jordansparks]

The Ack means that Tesia received them, not that Medicaid received them. All I can suggest is to be persistent. Send them all by paper immediately to get your accounts receivable in shape. Then track them more closely and follow up on them all daily. Medicaid should be able to tell you within about a day whether they received them. Hound Tesia with specific claims with specific dates and times. It sounds like a combined responsibility of Tesia and Medicaid to track down the problem. They just need you to motivate them. Let us know how it goes.

[eiscott]

A number of Medicaid plans have had significant processing difficulties since the NPI mandate went into effect in May. We have worked through the issues for most state Medicaid programs and would be happy to see if we can assist your office. Please let us know which Medicaid plan you are having difficulty with and we will gladly help.

Best regards,

Scott

[parksjdp]

A number of Medicaid plans have had significant processing difficulties since the NPI mandate went into effect in May. We have worked through the issues for most state Medicaid programs and would be happy to see if we can assist your office. Please let us know which Medicaid plan you are having difficulty with and we will gladly help.

Best regards,

Scott

We are in Iowa (Iowa Medicaid Enterprise - IME). As of right now, I am not sure which end it is on. Tesia says IME, IME says Tesia. I assume EDI processes for medicaid and that is where you come in. Thanks for attempting to help me and getting this straightened out.