Payer Issue

Rejection Message:

PAYER RESPONSIBILITY SEQUENCE NUMBER- INVALID, MUST NOT HAVE A SECONDARY PAYER WITHOUT A PRIMARY PAYER, MUST NOT HAVE A TERTIARY PAYER WITHOUT A PRIMARY AND SECONDARY PAYER

Possible Causes:

This payer may not be receiving the ERA information

Possible Solutions:

You can either mail the claim to the secondary payer with an attached EOB, which will most likely result in no payment since there was no amount allowed by the primary, or you can call the insurance company to get more information directly from them about the reason for this rejection message.

Rejection Message:

MM/DD/YYYY 17-29-14 ACK/REJECT INVAL INFO - INFORMATION SUBMITTED INCONSISTENT WITH BILLING GUIDELINES. USAGE- AT LEAST ONE OTHER STATUS CODE IS REQUIRED TO IDENTIFY THE INCONSISTENT INFORMATION.

Possible Causes:

The payer requires further information regarding a corrected claim.

Possible Solutions:

Information was not updated in the Claim Frequency Information fields.  

IMPORTANT: Please note that Medicare cannot receive corrected claims electronically, and must be submitted as a paper claim.  Submitting these corrected claims can cause rejections to generate in the claim.

Rejection Message:

MM/DD/YYYY 17-29-14 ACK/REJECT INVAL INFO - CLAIM FREQUENCY CODE

Possible Causes:

The payer requires further information regarding a corrected claim.

Possible Solutions:

Information was not updated in the Claim Frequency Information fields.  

IMPORTANT: Please note that Medicare cannot receive corrected claims electronically, and must be submitted as a paper claim.  Submitting these corrected claims can cause rejections to generate in the claim.

Rejection Message:

MM/DD/YYYY 17-29-14 ACK/REJECT INVAL INFO - PAYER ASSIGNED CLAIM CONTROL NUMBER

Possible Causes:

The payer requires further information regarding a corrected claim.

Possible Solutions:

Information was not updated in the Claim Frequency Information fields.  

IMPORTANT: Please note that Medicare cannot receive corrected claims electronically, and must be submitted as a paper claim.  Submitting these corrected claims can cause rejections to generate in the claim.

Rejection Message:

Message from payer received: MM/DD/YYYY 23-47-46 TRADING PARTNER HAS FORWARDED THE CLAIM TO THE PAYER, WAITING FOR ACKNOWLEDGEMENT FROM THE PAYER; MM/DD/YYYY 23-26-10 TRADING PARTNER HAS FORWARDED THE CLAIM TO THE PAYER, WAITING FOR ACKNOWLEDGEMENT FROM THE PAYER;MM/DD/YYYY 01-20-17 PAYER ACKNOWLEDGED RECEIPT OF THE CLAIM; MM/DD/YYYY 12-28-06 SUB-ELEMENT SV101-07 IS USED. IT SHOULD NOT BE USED WHEN LOOP 2410 IS USED AND HCPCS CODE FROM SV101-02 IS NOT FROM EXTERNAL CODE LIST - NOT OTHERWISE CLASSIFIED CODES (NOC). SEGMENT SV1 IS DEFINED IN THE GUIDELINE AT POSITION 3700.

Possible Causes:

The NDC code is missing or invalid

Possible Solutions:

Manually add or change the NDC code within the claim and resubmit.

Rejection Message:

Message from payer received: MM/DD/YYYY 23-47-46 TRADING PARTNER HAS FORWARDED THE CLAIM TO THE PAYER, WAITING FOR ACKNOWLEDGEMENT FROM THE PAYER; MM/DD/YYYY 01-20-17 PAYER ACKNOWLEDGED RECEIPT OF THE CLAIM; MM/DD/YYYY 23-26-10 TRADING PARTNER HAS FORWARDED THE CLAIM TO THE PAYER, WAITING FOR ACKNOWLEDGEMENT FROM THE PAYER; MM/DD/YYYY 12-51-24 CATEGORY- ACKNOWLEDGEMENT/RETURNED AS UNPROCESSABLE CLAIM THE CLAIM/ENCOUNTER HAS BEEN REJECTED AND HAS NOT BEEN ENTERED INTO THE ADJUDICATION SYSTEM STATUS- DUPLICATE OF A PREVIOUSLY PROCESSED CLAIM/LINE

Possible Causes:

The claim has been submitted more than once. The claim may still be processing.

Possible Solutions:

Check Claim Log to see if the claim was sent out multiple times. Contact the payer to see if claim needs to be resubmitted.