Secondary EClaims - Date Primary Paid missing?

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atd
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Secondary EClaims - Date Primary Paid missing?

Post by atd » Tue May 24, 2011 10:40 am

We just started receiving rejections from insurance companies for our secondary e-claims, with the error message "no primary paid date". Looking at the X12 file, I see that the amount paid by primary is being sent (i.e. AMT*D*94.40~), but I do not see anywhere in the file that includes the date paid.

Secondary claims were being paid for the last 6 months, the rejections just started happening last week. The rejections are from multiple insurance companies.

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jordansparks
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Re: Secondary EClaims - Date Primary Paid missing?

Post by jordansparks » Tue May 24, 2011 7:13 pm

It looks like it's always included for secondary claims. Look a few lines below the AMT line, down below the other subscriber info. The line starts with
DTP*573*D8*
The 8 numbers following the above are the date.
Jordan Sparks, DMD
http://www.opendental.com

atd
Posts: 404
Joined: Thu Mar 27, 2008 2:28 pm
Location: Minneapolis, MN

Re: Secondary EClaims - Date Primary Paid missing?

Post by atd » Wed May 25, 2011 5:19 am

I didn't find it because I was searching for the date the primary claim was received - the date in that line is actually the date the secondary is sent. Even if that is fixed, it doesn't look like this is the cause of the denials. Any other ideas? We use Tesia.

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jordansparks
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Re: Secondary EClaims - Date Primary Paid missing?

Post by jordansparks » Wed May 25, 2011 5:41 am

After reviewing the code, it does indeed look like it's always sending today's date. And while that is a bug, it's actually usually accurate. You usually do enter the primary payment and then send the secondary immediately, so it would almost always be today's date anyway. So I don't see how that could be causing a rejection. The date is getting sent. So if it's getting rejected by the carrier, all I can think of is to call them and ask what the problem is.
Jordan Sparks, DMD
http://www.opendental.com

atd
Posts: 404
Joined: Thu Mar 27, 2008 2:28 pm
Location: Minneapolis, MN

Re: Secondary EClaims - Date Primary Paid missing?

Post by atd » Wed May 25, 2011 5:49 am

Ideally they would get sent the same day, but that isn't always the case - especially when we have to resend claims that haven't been paid. I agree that this is not the cause of the rejections, although it should be more accurate.

This is happening with multiple insurance companies and when we called them they said the date wasn't being sent - but Tesia said they just pass along what is sent from Open Dental. The hard part is finding someone at the insurance company that knows anything about eclaims - they always reference the "boxes" on the paper claims, which is irrelevant. I guess I'll keep trying to reach someone knowledgable.

atd
Posts: 404
Joined: Thu Mar 27, 2008 2:28 pm
Location: Minneapolis, MN

Re: Secondary EClaims - Date Primary Paid missing?

Post by atd » Fri May 27, 2011 5:43 am

This was a problem with our clearinghouse, not Open Dental. They have since fixed the issue.
I'd still like to see the correct date sent from Open Dental. Thanks.

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