Payer Rejections (PE)
Payer Rejections
Payer Rejections Overview Payer Rejections Overview When a Claim is submitted electronically, the information on the individual Claim is matched with the information the Payer has on file. If the information is not in alignment with the Payer ...
Payer Rejection Articles
Payer Rejections Payer Rejections Overview Acknowledgement/Receipt Payer Rejection: A6 -A1-;Acknowledgment/Receipt Adjudication Date Payer Rejected: INVALID ADJ PAYMENT DATE Claim Filing Indicator (CFI) Payer Rejection: INVALID FILING INDICATOR CODE ...
Sequestration CO253
Sequestion CO253 Missing Sequestration Adjustment CO253. Acknowledgement/Rejected for Missing Information. The Claim/Encounter is missing information specified in the Status details and has been rejected Status: Federal sequestration adjustment ...
Payer Rejection: INVALID FILING INDICATOR CODE 'CI'
PE: A6 PSBR0905-INVALID FILING INDICATOR CODE 'CI' PSBR0906-INVALID FILING INDICATOR CODE 'CI' The Claims Filing Indicator (CFI) is not correct. Resolution: Check the Claims Filing Indicator on the Insurance. Example: The CFI is CI (Commercial) in ...
Payer Rejection: CHARGE MUST BE GREATER THAN ZERO [PE]
PE: A6 - CHARGE MUST BE GREATER THAN ZERO [PE] The Charge was sent with a $0.00 Fee. The Payer does not accept $0.00. Resolution: Three options for Resubmission Enter a Fee for the Line Item/Charge. Exclude the $0.00 Charge from the Claim. If the ...
Payer Rejection: Other Insurance Coverage
A6 ACK/REJECT MISS INFO - OTHER INSURANCE COVERAGE INFORMATION (HEALTH, LIABILITY, AUTO, ETC.). The Patient has other Insurance that may be Primary. This often occurs when a Patient has a Medicare Advantage Plan, and the Patient presented the red, ...
Payer Rejection: Entity Not Found Patient/Insured/Subscriber/Dependent
A6 ACK/RETURNED - ENTITY NOT FOUND. USAGE- THIS CODE REQUIRES USE OF AN ENTITY CODE. - PATIENT A6 ACK/RETURNED - ENTITY NOT FOUND. USAGE- THIS CODE REQUIRES USE OF AN ENTITY CODE. - INSURED A6 ACK/RETURNED - ENTITY NOT ELIGIBLE. USAGE- THIS CODE ...
Payer Rejection: Invalid Info - Entity's NPI Usage
A6 ACK/REJECT INVAL INFO - ENTITYS NATIONAL PROVIDER IDENTIFIER (NPI). USAGE- THIS CODE REQUIRES USE OF AN ENTITY CODE This is a common error from Medicare, but other Payers may use it as well. The payer is indicating that either the NPI that you ...
Payer Rejection: Smart Edit
Medicare started the concept of Smart Edits. The Claim rejects at the Clearinghouse level with an alert explaining that the Claim may be denied when processed. Some claims are rejected by a Smart Edit and do not enter the claims processing system. ...
Etactics Note: Previously Rejected on Earlier Report
Reason for rejection The Claim was sent to the Payer and was rejected. The claim was resubmitted to the payer without making the changes. Resolution On the Encounter Dashboard, select the Claim History link in the Policy Breakdown panel. In the ...