Overview
The unique part about MN MA ERAs will be that any charge to the client will appear as CARC code 142, which indicates a Monthly Medicaid patient liability amount, also known as a spend down. Similar to an HSA, there will be times when a payment comes through on an ERA from the payer to be applied towards the client's bill amount. On a MN MA ERA this will appear with a claim number as 0.
Saving the Client Responsibility
- Post the ERA as usual.
- When you see a Patient Responsibility CARC 142, select Transaction Type Deductible Adjustment.
- Save.
Determining the Client and DOS on the 0 Claim
- Click the 0 claim link.
- The client's name will be listed on the left in the Client column
- Locate the Claim Start date and Client name.
- This will be the DOS to apply the payment towards.
- Locate the Paid amount listed to know how much money to allocate to the client's bill line.
- Go to the Payments module > locate the client > double-click to open up the client's payment window.
- Locate the DOS in the Payments window.
Applying the Payment to the Client Balance
- In the Payment window, verify that the correct DOS is listed.
- On the Copay, Coinsurance, Deductible bill line click new.
- Click Select other payment.
- In the Search window, enter in the MN MA ERA payment reference number and select.
- Verify the Transaction Type is Payment.
- If the ERA payment reference is in a closed period you will need to take additional steps. Please submit a ticket to Procentive Support for additional instructions.
- Verify the amount being paid from the ERA is the amount listed to the right of the transaction type.
- Click Save.
- You will receive a pop-up warning that you are applying a payment to a different payer, in this situation that is okay.