The Pulse

Medicare Coinsurance and/or Deductible Claims Submission!!:
Currently, when a coinsurance and/or deductible claim does not automatically crossover to EDS electronically, providers have the option of submitting a paper claim with a legible copy of the EOMB attached. The information on the paper claim must be the same information submitted to Medicare and must mirror the EOMB exactly.

Effective immediately, in addition to the above criteria, providers must hand write or type the word "Medicare" in the header of the EOMB when submitting coinsurance and/or deductible claims to EDS for processing. The absence of "Medicare" in the header on the EOMB will result in the claim and EOMB being returned to the provider.

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