Claim Rejection unknown issue

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Katelyn K. MacDonald

• February 13, 2023 03:55

Hello, 

"Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system.
Patient. Individual receiving medical care's name, address, phone, gender, DOB, marital status, employment status and relation to subscriber. N70008 Patient last name submitted on the claim does not match any member listed on this policy. NOTE To obtain the correct patient information submit an eligibility transaction. Update the claim and resubmit. (A3 - 173)"

Client has reported that no changes have occurred with insurance provider and all information is consistent with previous successful claim submissions. I'm unsure if anyone has other ideas with how to resolve? Thank you! 

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  Janna Levi

  • April 25, 2023 17:29

  Hello - I just received the same rejection on a claim submitted. Did you ever receive an answer about how to resolve this?

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