Payer Rejection: Rejected Entity not Eligible/not approved for Dates of Service

Payer Rejection: Rejected Entity not Eligible/not approved for Dates of Service

PE: A6 -A3-;Rejected;Entity not eligible/not approved for dates of service

ERROR NO MEMBER ID MATCH FOR 'TEST,BOBBY H12345678' BY SERVICE DATE NOT ELIGIBLE

 

  • The Subscriber was not found or was not eligible on the DOS.

Resolution:

  • Compare the Insurance Card on file with the information in the System.

    • Is the Claim being sent to the correct Payer?

  • Verify who the Policy Holder is.

  • Check Eligibility.

  • Verify with Patient.


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