Some payers require the remaining patient liability, also known as the AMT EAF segment, on claims to review and submit payment as a secondary or tertiary payer. For this reason, there is an Insurance setting that allows the remaining patient liability to be passed from the primary payer's remit or payment to a secondary or tertiary payer claim.
This setting is called 837 - Include AMT*EAF segment and must be turned on to send the remaining patient liability.
See your insurance payer's claim or COB (coordination of benefits) rules to confirm if this setting is needed.
Turn on the 837 - Include AMT*EAF segment
- In the top navigation bar, click Administration and then click Insurances.
- Search for and select your intended payer.
- Click on the 837 Options tab.
- Check the 837 - Include AMT*EAF segment.
- Click Save.
See what changes in an example scenario:
| Without 837 - AMT*EAF segment | With 837 - AMT*EAF segment |
|---|---|
Result: Medicaid (secondary) rejects the claim |
Result: Medicaid (secondary) accepts, adjudicates, and sends payment for the claim (if it is a service you have contracted with the insurance). |
Here's what the electronic claim (837) looks like with the AMT EAF segment: