Therabill Support Specialist
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Category: Acknowledgement/Rejected for Invalid Information The Claim/Encounter has invalid information as specified in the Status details and has been rejected Status: Entity's commercial provider id
The payer is rejecting stating that you have provided an nvalid Entity's Commerical Provider ID. A claim can have up to three providers on it. The three possible providers are as follows. Bill...
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ACK/RETURNED - ENTITYS ID NUMBER. - PATIENT
There are many reasons why you may be getting this error. With this type of error, you may need to call the insurance company to check on why they cannot find the member. While on the phone wit...
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Value of element NM109 is incorrect. Expected value is National Provider ID (format is 10 digits with optional 80840 prefix and last check digit) when NM108=XX. Segment NM1 is defined in the guideline at position 2500. Invalid data:
Since the payer did not mention a specific loop in their rejection message, we cannot determine if they are referring to the rendering provider NPI or the billing provider NPI. You will want to ch...
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124 - Entity's name, address, phone and id number. Usage: This code requires use of an Entity Code.
Usually, with this rejection message, the payer is supposed to send additional information indicating who the 'Entity' is. Unfortunately, sometimes they do not. The various types of 'Entities' tha...
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Billing Provider Zip Code Invalid or Doesnt Match State Code
The payer is stating that the Zip code you are sending is not a Zip code within the State that you are referencing on the claim for the billing provider. There are several places within Therabill ...
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INVALID PREFIX FOR DATE OF SERVICE :
Blue Cross Blue Shield uses what is called an alpha prefix on their primary ID (insured ID, subscriber ID). This alpha prefix is what they use to route claims internally to the correct state offic...
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557 INVALID PATIENT LAST NAME (NO SYMBOLS)
There are many reasons why you may be getting this error. With this type of error, you may need to call the insurance company to check on why they cannot find the member. While on the phone wit...
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Dependent not eligible.
There are many reasons why you may be getting this error. With this type of error, you may need to call the insurance company to check on why they cannot find the member. While on the phone w...
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31 - Subscriber and policyholder name mismatched.
There are many reasons why you may be getting this error. With this type of error, you may need to call the insurance company to check on why they cannot find the member. While on the phone wit...
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If either of PRV02, PRV03 is present, then all must be present. The syntax rule P0203 of Segment PRV is violated. Segment PRV is defined in the guideline at position 2550. Invalid data: PXC
The PRV segment is where the taxonomy code goes on the EDI claim. The payer is most likely rejecting this because you did not supply a taxonomy code for this therapist. In Therabill, go to your p...