You may see the error message in two different formats.
- Element SBR05 is missing. It is required when SBR01 is not 'P' and payer is Medicare. Segment SBR is defined in the guideline at position 2900.
- Insurance Type Code may be used only for non-Primary Medicare Payer. Element SBR05 is used. It should not be used when element SBR01 is 'P.' Segment SBR is defined in the guideline at position 2900.
This error appears as a rejection in the in the Electronic Module. This claim rejection is specific to clients with Medicare. There is a discrepancy in how Medicare is set up for the client (as a primary or non-primary payer) and whether Medicare is listed as the primary payer for the service submitted on the claim.
- Go to the Clients Module.
- Double-click the client you are having issues with.
- Click the Payers tab.
- You will be locating the Medicare payer (keep in mind this may be a secondary or tertiary payer for the client).
- Click the Enrollment sub-tab
- The field Primary insurance type (code for Medicare as secondary) must be set to Medicare is Primary if Medicare is truly the primary payer.
- Select one of the other options if Medicare is not the primary payer.
- Click Save.
- Return to the invoice and resend the claim.