Medisphere ECS

Medicare EOB Rejection to Texas Medicaid Application Conversion System (ECS)

The purpose of ECS is to quickly and easily convert Medicare EOB’s that were rejected in the crossover process to Texas Medicaid (MRAN Form Crossover Claim Type 30).  This is usually the result of a patient having Medicare as the primary payer and TX Medicaid as the secondary payer when Medicare isn’t aware or set up with TX Medicaid as a secondary.  This causes the claim to be rejected and the providers billing department must complete a standardized pdf form distributed by the State of Texas.

ECS was developed to help providers take a very manual and time intensive process that on average takes 10 minutes per form to complete to a simple web based interface that can complete over 50 forms in just a minute and a half.  The idea behind the system was to not only save time and efficiency when processing these required filings but to also increase the accuracy of the data to 100% on every form decreasing the rate of successive rejections while providing the convenience of an easy to use cloud based solution.