Electronic Claim Errors
A knowledge base of common electronic claim errors and possible solutions.
- Invalid Rendering Physician NPI Format (Box 24J)
- 560 - Entity's Additional/Secondary Identifier. Usage: This code requires use of an Entity Code.
- 156 - Patient relationship to subscriber
- NAME AND OR DOB SENT IS INVALID
- Element NM106 (Name Prefix) is present. This Element is marked as Excluded and therefore must not be present in the data. Segment NM1 is defined in the guideline at position 0150.
- BILLING PROVIDER TAXONOMY CODE: REQUIRED; MUST BE ENTERED FOR PAYER
- 251 - Total anesthesia minutes.
- Claim Rejected - No ErrorId Claim ID 193912752 Date Of Service 03/20/2015 Rejected Reason ST 000307 LineNo 11 SEG REF LOOP 2010AA
- Patient Street Address Required
- 164 - Entity's contract/member number. Usage: This code requires use of an Entity Code.
- INVALID SUBSCRIBER CONTRACTMEMBER NUMBER
- INVALID ALPHA-PREFIX ON SUBSCRIBER ID
- Clm BCBSNE Rule Billing Tax ID not found
- Entity not eligible not approved for dates of service.
- Procedure Quantity is invalid.
- CLAIM REJECTED BY TRADING PARTNER
- Segment DTP (Date - Accident) is missing. It is expected to be used when segment REF (Property and Casualty Claim Number) is used
- 128 - Entity's tax id. Usage: This code requires use of an Entity Code.
- 34 - Subscriber and policyholder name not found.
- The claimencounter has been rejected and has not been entered into the adjudication system. Submitted claim number (ICN) is invalid or has been purged if over 3 years. :
- PATIENTS RELATIONSHIP TO INSURED: INVALID; MUST INDICATE SELF FOR PAYER
- Sex-Nomtch
- INVALID SUBSCRIBER MEMBER ID
- Clm BCBSNE Rule This policy number does not have coverage for medical services
- Member-Unknown
- PROV NPI DATA NOT RECOGNIZED BY WELLMARK
- InvalidData BL Location 2000B - SBR09 Clm Claim must be billed direct to Blue Shield CA.
- REJECT- UNABLE TO IDENTIFY AS MEMBER
- ACCIDENT DATE: INVALID; MUST BE LESS THAN OR EQUAL TO SERVICE FROM DATE
- Modifier 0, on line 00 is invalid