Electronic Claim Errors
A knowledge base of common electronic claim errors and possible solutions.
- Invalid Referring Name Format (HCFA Box 17, ANSI 2310A NM1)
- Missing/Invalid Other Insured Name (HCFA box 9, UB box 58)
- 30 - Subscriber and subscriber id mismatched.
- MEMBER WAS NOT ELIGIBLE FOR BENEFITS WITH THIS PAYER FOR THE SERVICE DATE(S) ENTERED
- ACK/REJECT INVAL INFO - SUBSCRIBER AND SUBSCRIBER ID NOT FOUND.
- ACK/RETURNED - ENTITY NOT ELIGIBLE FOR BENEFITS FOR SUBMITTED DATES OF SERVICE. - INSURED OR SUBSCRIBER
- Payer Specific Rejection: CPT/HCPCS code used requires Referring physician (HCFA Box 17, UB Box 78)
- 145 - Entity's specialty/taxonomy code. Usage: This code requires use of an Entity Code.
- ACK/RETURNED - ENTITY NOT FOUND. - PATIENT
- 510 - Future date. Usage: At least one other status code is required to identify the data element in error.
- RENDERING NOT PRESENT :
- Entity not eligible. (Dependent)
- Individual relationship code (loop 2000B, SBR02) must equal Self.
- INVALID SUBSCRIBERMEMBER ID
- INVALID MBR DOB
- NO HORIZON BCBSNJ ENROLLMENT FOUND FOR THE PATIENT NAMED ON THE CLAIM
- 562 - Entity's National Provider Identifier (NPI). Usage: This code requires use of an Entity Code.
- 727 - Accident date
- 400 - Claim is out of balance
- 643 - Service Line Paid Amount
- Returned to Entity
- Entity not found
- 693 - Amount must be greater than or equal to zero. Usage: At least one other status code is required to identify which amount element is in error.
- REND NPI NOT ON BCSYS FAXTO 225_297_2750
- Rejected Unprocessable Claim N70005 Member Identification Number is not formatted correctly.
- 578 - Insurance Type Code
- Rejected Unprocessable Claim N70004 Submitter is not authorized to submit on behalf of Billing Provider
- Invalid Rend Physician ID Number
- RENDERING PROVIDER IS MISSING ON MEDICAL CLAIM
- Entitys commercial provider id