1. NPM Knowledge Base
  2. Medical billing in dentistry

Apex MA83 Medicare Response

How to handle a denial remark code MA83 when billing Medicare DME electronic claims through the APEX clearinghouse


For DentalWriter Software clients who are utilizing Apex clearinghouse to submit their medical claims electronically, if an ERA response is received from Medicare that states “MA83 Did not indicate whether we are the primary or secondary payer”, this means one of two things:

 

  1. The word “NONE” was missing from field 11 on the medical claim when submitted, or
  2. If the word “NONE” was present in field 11 on the medical claim when submitted, it is likely the claim was “dropped to paper” by Apex clearinghouse, meaning the claim was printed out and physically mailed to Medicare. 

 

Below is a screenshot of what this response will look like:

 


The good news is, both situations are easily fixable:

 

  1. If you find that the word “NONE” was missing from field 11 when the claim was submitted, simply add it and resubmit the claim. 

 

  1. If you find that your medical claim to Medicare was dropped to paper (which you can find by logging into your Apex one touch portal and selected the “claim status” tab. Locate the claim by searching the patient’s name and the date range, and if there is an icon of a piece of paper on the left side of the line item, it was dropped to paper), then it is likely that an EDI packet must be completed and submitted. Once completed, your medical claims are able to be delivered electronically to Medicare from then on. This will decrease the processing time for Medicare claims as well. 

 

 

To request an EDI packet, contact Apex Support (800-840-9152) and let them know that an EDI packet needs to be completed for Medicare DME. It is important that you specify for Medicare DME. The instructions and link to complete will be e-mailed to you. Processing typically takes 7-10 days, and then you will receive an e-mail alerting you that your EDI packet has been processed/approved. Once that e-mail confirmation is received, you can resubmit any claims that were denied for this reason for processing.