secondary claims

Robin · Post by **Robin** » Fri Feb 18, 2022 12:53 pm

I have been sending secondary claims electronically for years, and this is the first time I got this error message.

Value of element CAS05 has been already used. Claim Adjustment
Reason Codes are expected to have unique values within segment CAS. Segment CAS is defined
in the guideline at position 5450. Invalid data: 96

This was a zero payment by the primary insurance, but I have had this before.
Any help would be appreciated!

Post by **Gavin Walker** » Tue Feb 22, 2022 8:57 am

The primary carrier gave an adjustment reason code if 96 which is non-covered charge. Therefore, the remaining balance is the patient's responsibility rather than secondary insurance responsibility.

Robin · Post by **Robin** » Thu Mar 03, 2022 8:35 am

I have sent these to the secondary before as they always pick up the deductibles and coinsurance and have never had this happen before.
Thanks anyway

Post by **Gavin Walker** » Fri Mar 04, 2022 9:46 am

Well, the insurance is not covering this anymore. You'll need to contact the PRIMARY insurance to find out why it is not covered. Possibly they require an authorization, etc. We will need more details on why the service was not covered.