| |
|
PROVIDER ID IS MISSING OR INVALID |
The
provider Identification Number must be entered in 24 and 33 Pin#.
Add provider id in ADM/ProviderID |
|
PAYER ID=00803: ENTER SOURCE OF PAY 'C' (EMPIRE MEDB) OR 'G' (EMPIRE
BLUE SHIELD) |
If
the Payer Organization ID entered is equal to 00803 then the
Source of Payment code must be equal to 'C' (Medicare) or 'G'
(Empire Blue Shield).
Modify ADM/Insurance/Editing Indicator: Choose Medicare for
Medicare, BCBS for BCBS
Don't choose Commercial as Editing
Indicator for Medicare/BCBS! |
VALID NEIC PAYER ID IS REQUIRED
|
If
Source of Payment is equal to 'F' (Commercial Payer) or a 'H'
(Champus)
and the Claim Filing Indicator is equal to 'P' a valid NEIC Payer ID
must be entered. |
PATIENT'S STATE, IF PRESENT, IS INVALID
|
Check the patient address, no spec characters, use uppercase letter |
PATIENT'S ZIP CODE, IF PRESENT, IS INVALID
|
Check the patient address, no spec characters, use uppercase letter |
- PAYER
STATE, IF PRESENT, IS INVALID
- INSURED
STATE, IF PRESENT, MUST BE VALID
- INSURED
ZIP CODE, IF PRESENT, MUST BE VALID
|
Check insured information, no special characters, use uppercase letter |
|
LINE CHARGES ARE MISSING, OR NOT NUMERIC AND MUST BE > ZERO |
Charges must be >zero, check 24 |
IF FB1 PRESENT: REND PROV ORGANIZATION OR LAST & FIRST NAME REQ
|
NEIC requires that all claims that contain the FB1 record must also
contain the Rendering
Provider Last and first Name or the Organization name. |
PATIENT'S LAST NAME CONTAINS INVALID CHARACTER(S)
|
The
first character of the last name may only contain a value of A-Z
(may not be a
space or special character). The remainder of the field may contain
A-Z, 0-9, period,
comma, hyphen, and trailing spaces. No other special characters or
embedded spaces
are allowed. |
PATIENT'S FIRST NAME CONTAINS INVALID CHARACTER(S)
|
The
first character of the first name may only contain a value of A-Z
(may not be a
space or special character). The remainder of the field may contain
A-Z, 0-9, period,
comma, hyphen, and trailing spaces. No other special characters or
embedded spaces
are allowed. |
INSURED ID FORMAT IS INVALID
|
The
Insured ID may contain A-Z, 0-9, No other special
characters are allowed. The Insured ID may not contain all 1's, 2's,
3's, 4's, 5's, 6's,
7's, 8's, 9's or 0's. May not contain any of the following literals:
1234567890, NONE, UNKNOWN, INDIVIDUAL, SELF |
|
WRONG BODY SIZE FOR PREFIX ENTERED (REMOVE SUFFIX IF PRESENT) |
If an alpha character is present in any of the first three positions
of the Insured ID
Number (subscriber ID) field, the subscriber ID will be considered
to have a prefix. When
the insured is an Empire subscriber, the subscriber ID body must
contain the number of
digits required for the prefix on Empire¡¯s Central Certification
File (internal use only).
Usually, the ID body is 9 digits except for FEP ID¡¯s that have a
¡°R¡± prefix followed by an 8
digit body. Otherwise, the ID body should be between 4 to 14
alphanumeric for out of area.
(non-Empire) subscribers. This information is available on the
subscriber¡¯s insurance
card.
Note1: This edit does not apply to an Insured ID
Number that has a prefix of YLG, GC,
G, YLN, or 3HN.
Note2: Entry of a suffix is not allowed.
Example: correct format of subscriber ID YLS125566788 01 is as
follows:
Prefix = YLS
Body = 125566788
Suffix = Leave blank (01 is a suffix).
|
SUBSCRIBER ID MUST BE 6 TO 9 NUMERICS WHEN ID HAS NO PREFIX
|
When the Insured ID Number (subscriber ID) is for an Empire
subscriber (Payer ID is
00803 or spaces) and the ID does not begin with a prefix, the
Insured ID Number must
contain at least six and no more than nine numbers.
Note1: This edit does not apply to an Insured ID No.
that has a prefix of YLG, GC, or G.
Note2: If the Payer Organization ID, Field 7, contains spaces,
Empire will default this
field to ¡°00803¡± to perform validation.
Note 3: The valid format for an Insured ID Number without a prefix
is as follows:
Body = nnnnnn (minimum of 6) to nnnnnnnnn (maximum of 9)
Suffix = Leave blank. |
|
TYPE OF SERVICE MUST EQUAL '05' |
If
the CPT code is a dynostic lab code, type of service=05. After
create a claim, add '5' or '05' in 24/TOS position manually |
|
DENIED CODE 4 |
A
required modifier is missing. After create a claim, add modifier in
24 manually |
|
NETWORK ID\REQ: RENDER NETWORK ID FOR PAYER |
Please check 24 and 33 Pin# in the rejected claim |
|
INSURED NAME/ADDRESS DOES NOT MATCH CARRIER FILES FOR SSN/INSURED ID |
Check patient's eligibility |
|
SOCIAL
SECURITY/EMPLOYEE NUMBER NOT FOUND ON CARRIER FILES
|
Check
patient's eligibility
|
Your claims are printing incorrectly because your
offset is incorrect. Click on the link below and say yes when it prompts
you if you are sure you want to change the registry settings.
You need enter the PayerID for the insurances before
you can send claims electronically. Here is a detailed explanation.
While there are a number of reasons that
your computer might be acting erratically, one recent phenomenon that
has been causing
conflicts with iClinic and your Internet Explorer browser is spyware
and adware. Spyware or adware cause conflicts with a number of Internet
based software. You can remove adware from your computer through a number
adware/spyware removal
programs. Go to http://www.cexx.org/adware.htm for
more information about spyware and adware.
