LIS/LICS consumers (LNET)

Beneficiaries with Medicare who have limited income and assets may qualify for Extra Help with the costs of their prescription drugs. This program is also known as LIS, or the Part D Low Income Subsidy. The Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS) work together to provide the benefit. [source/more info]

When you receive an "Error" when submitting an E1 check for someone's Medicare Part D (See Below).

Hit okay and you will then get a claim response window like we are used to seeing, that will either have a green check or a red "X". If you receive a green check, then you will want to look through the information that was provided in the response. Mainly you want to look for anything that says LNET in the "Response Message" section under "Plan Type" (See Below). LNET is a special plan for someone who is LIS/LICS (Low Income Subsidy/Low Income Cost-Sharing).

This plan will be added similarly to Med-B. You will need to obtain their Medicare A/B number, and also the Zip code from the response on the Med A/B check. You will also need their address. If you have questions on how to obtain this information, let me know.

Enter a new Method of Payment under their Payment Plans, which will be LNT1 select the pricing option (LNT1), and then the forulary (Default). Complete all of the fields that have been generated. Make sure you use CAPS LOCK when filling this information. The "Patient Sate/Provice Address" will be the postal abbreviation (ie: TN, KY, IN, OH, etc..) and the "Patient Zip/Postal Zone" is going to be the first 5 digits of the zip code provided by the Med A/B check, not the one that is in the "Nursing Station" address. The "Cardholder ID" will be (usually) their Medicare Number, the ID that you got on the Med A/B check. "Person" and "Relationship" are always 1. Don't worry about the "Group ID".

Try to run the claim again.