Reporting other insurance on Medicaid claims for Vision, NEMT and MIHP providers

If a Medicaid beneficiary has other insurance, that insurance typically needs to be reported on claims. Below are new instructions for three provider types who may no longer need to report other insurance on claims:

Vision providers

For Medicaid members with only Medicare as other insurance, we’ll accept the following procedure codes without Medicare insurance and payments being reported in the “Other Payer” field on the claim:

• S0620
• S0621
• 92340
• 92341

Currently, codes V2020 and V2025 still require providers to report Medicare insurance and payments in the “Other Payer” field.

NEMT and MIHP providers

Our systems are currently set up to reject claims for Medicaid members with other insurance from non-emergency transportation (NEMT) and maternal and infant health program (MIHP) providers, when those claims don’t list the additional insurance in the “Other Payer” field.

On Mar. 25, 2022, the state of Michigan updated its systems to allow these claims. We’re working on updating our own system edits to also allow these claims within the next quarter.

Until our update is made, we’ll require NEMT and MIHP providers to report other insurance in the “Other Payer” field, or providers can hold their claims until we've made the changes in our system.