Electronic Claim Errors
A knowledge base of common electronic claim errors and possible solutions.
- S103 SUB ID INACTIVE/SERV DT
- Rejected Entitys contractmember number.
- NPI is not Valid as Billing
- Prov-Unknown
- Segment REF (Billing Provider Secondary Identification) is used. It is not expected to be used when National Provider ID is mandated for use and NM109 is used in loop 2010AA. Segment REF is defined in the guideline at position 0350.
- Payer address line (loop 2010BB, N301) is required
- Rejected - Invalid Data Subscriber and subscriber id not found.
- 1 - For more detailed information, see remittance advice.
- Billing NPI is not valid as Rendering
- Patient Relationship Payer requires patient to be subscriber, enter data as subscriber
- CONTRACT IS MEDICARE ADV AND SOP IS BL
- E02 INVALID SUBSCRIBER ID FOR CARRIER CODE
- CONTRACT NUMBER NOT FOUND
- Billing Provider Tax ID not found
- Rendering practitioner information is missing
- Response not possible - error on submitted request data Cannot provide further status electronically.
- Claim rejected - Eligibility Not Found
- Member ID must be valid.
- Claim contains invalid UNIT value(s)
- Invalid Mbr
- INVALID MEMBER LAST NAME AND/OR FIRST NAME. VERIFY AND/OR CORRECT MEMBER ID, DOB AND GENDER
- Member not on file
- PAT LAST NAME NOT ON BC FILE
- Patient hierarchical level (loop 2000C) is not allowed.
- 746 - Duplicate Submission Usage: use only at the information receiver level in the Health Care Claim Acknowledgement transaction.
- Units or Minutes Must be Present and Valid
- 694 - Amount must not be equal to zero. Usage: At least one other status code is required to identify which amount element is in error.
- ACK/RETURNED - AWAITING NEXT PERIODIC ADJUDICATION CYCLE.
- 454 - Procedure code for services rendered.
- Element SV102 (Monetary Amount) has a data type of \'Numeric\' (R). Leading zeros are not allowed. Segment SV1 is defined in the guideline at position 3700