Add Medicare Override Data

Once you determine the Medicare account number and value you want to override, you must verify that the account information is correct and provide the override data to save the change.

Use this procedure to verify the Medicare account information and add an override value and comment about the change.

  1. Access the Medicare Override Verification page.
    1. Select Go To > Overrides > Medicare Override Add. The Add Medicare Override page opens.
    2. Type the number of the account you want to override in the Account Number field.
    3. Select the type of value you want to override from the Field Types list. For more information about searching for Medicare claims to override, refer to Specify a Claim to Override with Medicare Data
    4. Click Add Medicare Override. The Medicare Override Verification page opens.
  2. Review the account information to ensure the displayed account is the one you want to override.
  3. Type a new value in Override Value.
    • If you are forcing a reprice or voiding the account, it is only necessary to type a comment.
    • Length or other constraints might exist for these types of override: DRG, payor code or provider number.
  4. In Comment type a reason for the change or follow your internal procedure for such comments.
  5. Click Save Medicare Override.

The following table describes each of the fields on the Medicare Override Verification page.

Field

Description

Account Number

Patient account number (for UB claims) or insured ID (for CMS-1500 claims)

Admit Date

Date of admission for the account

Comment

Comment typed by user who created the override

Dates of Service

The range of date of Service From and date of Service To for the claim

DRG

Diagnosis Related Group code

Entry Date

Date the claim was entered into Contract Manager

Field to Override

Name of the field that is to be overridden

Latest Claim Override Made By

User ID of the individual who performed the last account override

Latest Claim Override Made On

Date of the previous override

Latest Claim Override Value

Last value added by override

Old Value

Value of the field before the override

Override Value

New override value

Payor Code

Payor code associated with the product

Provider Number

Provider’s tax ID number or ten-digit National Provider Identification (NPI) number required on all claims