Kidney Health Care Claims To Accept Benefit Stage Fields

On Sunday, April 1, pharmacies submitting Kidney Health Care (KHC) claims will have new claim submission requirements if the primary payer has financial amounts that apply to Medicare Part D beneficiary benefit stages. The following fields found in the “COB/Other Payments Segment” will be required when the beneficiary participates in a Texas Medicare Part D plan:

·        “Benefit Stage Count” (Field 393-MU)

·        “Benefit Stage Qualifier” (Field 393-MV)

·        “Benefit Stage Amount” (Field 394-MW)

For more information please download and refer to the KHC-specific claims billing payer sheet.  Pharmacies with questions regarding this change should contact the KHC Customer Service line at 1-800-222-3986.