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Customer Service Frequently Asked Questions
North Carolina - Third Quarter 2005
- I have submitted my claims multiple times and still have not received payment. Why are my claims not being paid?
- My claims are being denied with remark code MA114. What information is needed for these claims?
- We have not changed the patient's billing information for Medicare. Why are my claims being denied with remark code MA27?
- How can I check on a MCS issue that was reported?
- When do the mandatory electronic claim filing guidelines become effective?
- I have submitted my claims multiple times and still have not received payment. Why are my claims not being paid?
A.
Please allow at least 30 days for claims processing. At the end of the 30 day processing time, you should check the IVR for claims status. Often, when claims are submitted multiple times, they will deny as duplicate against each other.
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- My claims are being denied with remark code MA114. What information is needed for these claims?
A.
Effective for claims received on and after April 1, 2004 , (for any services rendered in a location other than "home"), the name, "physical" address, and zip code, indicating where the services were rendered, must be entered in Item 32 of the 1500 claim form. An incorrect or incomplete address, such as "P O Box", will cause the claim to deny with code MA114.
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- We have not changed the patient's billing information for Medicare. Why are my claims being denied with remark code MA27?
A.
Claims denying with code MA27 identify claims returned for "missing/incomplete/invalid entitlement number or name shown on the claim". The claims must be reported with the patient's information as shown on the patient's red, white, and blue Medicare identification card. If you receive MA27, the information should be corrected and submitted as new claims.
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How can I check on a MCS issue that was reported?
A. A webpage has been established in regard to the MCS transition, including a Provider Updates section for reported MCS issues and resolutions. You can access this webpage at http://cignamedicare.com/MCS/index.html.
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- When do the mandatory electronic claim filing guidelines become effective?
A.
Effective October 16, 2003 , providers and suppliers were required to bill their initial claims to Medicare electronically, unless the provider/supplier falls under the exception guidelines. However, effective July 1, 2005 , CMS will implement mandatory electronic claims submission. Please refer to MedLearn Matter 3815 posted to our What's New webpage (http://cignamedicare.com/partb/whatsnew.html) May 5, 2005 .
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