submit Bill to other Processor or primary payor???

[vtran007]

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Anyone know how to solve this problem without making the patient wait for an hour or so and then ask them their Medical card is not working and we need a IEHP or Molina card? Medical always do this without letting their patients know. For Molina, it is easy to solve (submit to RX and Amer or MOL and HC with the same first Medical numbers up to the Letter in the middle) but for IEHP, is there a number that I can call to get the subscriber ID? A phone number that I can get in contact with the pharmacy helpdesk ASAP. Sometimes, I try the social security number but that does not work.

 

[russ36]

I usually get that rejection with dual-eligible medicaid patients. Thus, instead of submitting to their medicaid plan I need to find their Medicare part-D plan. If your retail software has the option of doing a patient's Medicare part D search using the last 4 digits of their S.S. # you should be able to find the part D plan relatively quickly. If not, you can always call the Medicare help desk (1-800-Medicare) and they will provide you with the patient's Medicare D information as long as you have the patient's medicare # and the dates in which they became eligible.

 

[Transformer]

You must be working in Southern California. I deal with this issue all the time. Most of our patients have Medical and their primary payer is IEHP = Inland Empire Health Plan.

Have you tried looking this information up on the IEHP and/or Medical website?

If the patient has MEDICAL, you can access their records and find their primary payers on the medical website:

https://www.medi-cal.ca.gov/Eligibility/Login.asp



If MEDICAL displays that the patient has IEHP insurance, you can find their IEHP ID# from the IEHP website:

http://ww2.iehp.org/IEHP/Providers/

(Your pharmacy must have the proper IDs and passwords in order to access these websites)


If no ID or password, you're gonna have to call IEHP at 909-890-2049 during regular business hours.

Although when I worked at retail awhile back, there was a small machine that printed out a small label that showed what primary insurance the patient had.


Hope that helps..🙂

Anyone know how to solve this problem without making the patient wait for an hour or so and then ask them their Medical card is not working and we need a IEHP or Molina card? Medical always do this without letting their patients know. For Molina, it is easy to solve (submit to RX and Amer or MOL and HC with the same first Medical numbers up to the Letter in the middle) but for IEHP, is there a number that I can call to get the subscriber ID? A phone number that I can get in contact with the pharmacy helpdesk ASAP. Sometimes, I try the social security number but that does not work.

 

[vtran007]

You must be working in Southern California. I deal with this issue all the time. Most of our patients have Medical and their primary payer is IEHP = Inland Empire Health Plan.

Have you tried looking this information up on the IEHP and/or Medical website?

If the patient has MEDICAL, you can access their records and find their primary payers on the medical website:

https://www.medi-cal.ca.gov/Eligibility/Login.asp



If MEDICAL displays that the patient has IEHP insurance, you can find their IEHP ID# from the IEHP website:

http://ww2.iehp.org/IEHP/Providers/

(Your pharmacy must have the proper IDs and passwords in order to access these websites)


If no ID or password, you're gonna have to call IEHP at 909-890-2049 during regular business hours.

Although when I worked at retail awhile back, there was a small machine that printed out a small label that showed what primary insurance the patient had.


Hope that helps..🙂

👍 thanks
if I have other questions, I will ask later.