Clearinghouse Rejections (CE)
Rejection: Global Edit Patient Status Code are numeric Required element missing CL1 [CE]
A7:0 Global Edit Patient Status Code are numeric Required element missing CL1 [CE] The Admitted Type, Admitted Source, and Discharge Status are required on Institutional Claims. On the Encounter Dashboard, select the UB04 link in the Charge panel. ...
Clearinghouse Rejection Articles
If the Subscriber State (AB) is a Canadian province then Subscriber Zip Code (AB T8L0S2) must be six characters Referring Provider (23010A) is required to be a person 2300 NTE02 has a character limit of 80 characters Service Line 1 COB Claim ...
Clearinghouse Rejection: If the Subscriber State (AB) is a Canadian province then Subscriber Zip Code (AB T8L0S2) must be six characters.
CE: A7:0 If the Subscriber State (AB) is a Canadian province then Subscriber Zip Code (AB T8L0S2) must be six characters. The format (ANANAN) (A = ALPHA, N = NUMERIC) (no spaces) Example of a Canadian Zip Code: L2J4E2
Clearinghouse Rejection: Referring Provider (2310A) is required to be a person
CE - Referring Provider (2310A) is required to be a person (NM102 = '1') Referring Provider Library: If the full name of a Referring Provider is entered in the Last Name field, it is recognized as an institution instead of a person This puts a 2 in ...
Clearinghouse Rejection - 2300 NTE02 has a character limit of 80 characters
CE - 2300 NTE02 has a character limit of 80 characters EDI has an edit in place that will reject Claims that have greater than 80 characters in the 2300 NTE segment. This causes frequent issues with Ambulance Claims. We send the pick up and drop off ...
Clearinghouse Rejection: Service Line 1 COB Claim adjudication date
CE: Service Line 1 COB Claim, adjudication date is required for payer id 'MCRTX' Service Line 1 COB not balanced; Line Payments + Line Adjustments do not equal Line Billed Amount for Payer id MCRTX (Loop 2430) ***MCRTX is being used in the example. ...
Rejection: Missing or invalid information. Usage- At least one other status code is required to identify the missing or invalid information.;-Clm| Member ID (Loop 2010BA, NM109)
Reason for Rejection PAYER REJECTED: A6 -A3-;Rejected; Missing or invalid information. Usage- At least one other status code is required to identify the missing or invalid information.;-Clm| Member ID (Loop 2010BA, NM109) is invalid. Invalid Data ...
Rejection: Invalid ZIP code on Subscriber Loop. Bad ZIP 06479 [CE]
CLEARINGHOUSE REJECTED: A7:0 Invalid ZIP code on Subscriber Loop. Bad ZIP 06479 [CE] The Zip Code is invalid for the Subscriber, Loop 2010BA. If Subscriber is the Patient, check the Zip Code in the Patient's Demographics. If Subscriber is not the ...
Rejections Examples
Rejection: Invalid Subscriber ID Format for ___ Resolution: From the Patient Dashboard, verify Eligibility, view the Eligibility Report, view the Patient's Scanned Insurance Card, and/or call the Patient. Correct the Policy Number. On the Encounter ...
Rejection: Etactics Cannot Print Claims without the Full Payer Address
Reason for Rejection If you send primary claims to our clearinghouse to print, the Insurances Library must contain a full address. To fix this rejection: Select Libraries on the left Dashboard menu. Select Insurances to go to the Insurances ...
Rejection: Element SBR05 Must Contain ___ , or Claims with Medicare as Secondary Payer Require Valid MSP Type Code
To fix this rejection: From the Patient Dashboard, go to the patient's Insurance Policy. From the Medicare Secondary Reason dropdown list, choose the reason Medicare is the Secondary Payer (MSP). The lookup contains all valid MSP reason codes. If you ...
Rejection: Adjudication Date (2430*DTP*573) Cannot be Earlier than Service Date
Reason for Rejection This occurs when you have posted a primary payment and are sending the claim to a secondary payer. When posting the payment, you were attached to a Reference batch whose Post Date is before the Date of Service. Usually, this is ...