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Claim rejected with following error code: Claim/submission format is invalid. 239 Claim/submission format is invalid - Patient/2000C Loop used (A3 - 481)

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2 comments

  • Sue Elderbroom

    I have the same issue. Does anyone know what the issue might be? Also MVP claim.

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  • Kylie McKeighan

    For context, this payer requires that Box 6 is marked as "Self," even if the client's relationship to the primary insured is a dependent. This is because the two-digit suffix on a partner's or dependent's member ID acts as a unique member ID and this payer does not accept any claims which do not have the primary insured marked as "Self".


    That said, you can update this by going to the client's Overview page > Edit > Billing and Insurance tab. Then, scroll down to Insurance Info and click Edit. You can then update the Primary policy holder to Client. Please be sure to click Save from the fly-out window and Save Client at the bottom of the page.


    Then, you can follow the steps below to recreate and resubmit the claim:

    Download the claim and take note of the Clearinghouse Reference # for proof of timely filing. You can save it to the client's Overview page by following this guide: How do I store client documents?
    Next, delete the claim.
    Recreate the claim and confirm that Box 6 is marked as Self.
    Save and submit.

    If you have any other questions regarding this, please let me know. I'm happy to help.

    Warmly,
    Jessica A.
    Insurance Specialist

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