Kalderos is testing a new modifier submission feature to help better connect all stakeholders.
When Covered Entities review claims in Discount Hub (online portal), confirmed duplicates may be disputed with the respective State Medicaid Agency. If a Medicaid duplicate discount violation did occur in any of these claims, there's no further action needed from you. Kalderos and our customers will dispute the findings with your State Medicaid agency.
State Medicaid Agencies often request modifier information from CEs on disputed claims, causing Kalderos to reach back out to CEs like you for more information. We don’t want CEs to have to verify the same claims twice. That’s why we’ve added a new enhancement in the Discount Hub portal allowing Covered Entities to enter modifier information for claims added to your account through good-faith inquiries. The review of claims in the portal will still be the same process, with the addition of selecting the specific modifier (if applicable) that was used for a claim.
This new feature will be available to a small number of CEs to start, in order to get feedback. We’ve also included a text box to capture any input or details you have on specific modifier policies, context of claims, etc. Please utilize this text box to give feedback and details to our Product organization. We want to ensure this feature helps reduce CEs having to review claims twice from the state.
New feature capabilities:
Now when you click to respond to any inquiry you will be prompted with a new response drawer, where you can make the appropriate selection.
If you click on the ‘Yes’ response, you will be asked to select the modifier that was used on the transaction when transmitting it to the state. If no modifier was used, then you can choose that response as well.
There is also an additional Comments section now which allows you to input free text to add any context you wish to share.
Providing Feedback:
We always want to hear from you! You can click on the 'Help us improve' button in the left hand navigation to send anything directly to our product team, or reach out to your Customer Success Manager directly by clicking on the icon in the lower right hand side.