Entity code: What does this mean?
Answered
Accepted: Entity acknowledges receipt of claim/encounter. Note: This code requires use of an Entity Code. (20).
I got this for two of my submitted claims to BCBS. What does this means?
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Official comment
Hi Mayrena,
I hope you're having a great Monday! I took a look at your BCBS claims and it looks like they were all accepted. The status itself is the most important thing. Any other message that was sent, such as "This code requires the use of an entity code (20)" is an extra message that is included but it doesn't mean much until the payer processes the claim.
So, if your claims are in the Accepted status and have that message, you can ignore them until the payer processes the claims. If they reject your claims, then we can take a look. If they pay for them, then you can ignore it. In general, the claims will be processed with no issues.
Let me know if you have any trouble.
Thanks!Comment actions -
My claims are not in the accepted status. They were unable to submit them due to missing entity code, and this claim is rejected. I have previously submitted claims on these clients. I don’t know why it is all of a sudden saying this. I reached out to Simple Practice via email, still no word.
Mary-Ellen W
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I found the answer thanks to Dustin: go to accounts, then settings, then billing and services, then insurance and UNCHECK the box next to "SERVICE FACILITY LOCATION INCLUDE ON CLAIM FORM"
Simple practice really should send out to everyone to do this. If it stays checked, BCBS won't get claims submitted.
Mary-Ellen -
I got this: Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. (A3) Entity's primary identifier. Note: This code requires the use of an Entity Code. (755)
This was a claim sent to BCBS-MA; I have been sending claims to this payer for this client for nearly a year without any trouble. I have never received this message before. At first I thought it was because SP defaulted the location of the service to 02-telehealth (though the session was in the calendar with location "11-office") and so i fixed that and resubmitted. It was returned again. It is being returned by SP/the clearing house, not the insurer - I can tell this because it is getting returned less than 30 minutes after I submit it so it clearly hasn't had time to go through to be processed by the payer.
I have unchecked the box as recommended by Mary-Ellen, but I don't understand why it wasn't a problem for a solid year and all of the sudden it is a problem. I am sending this to SP as a help request as well because I can see that SP reps have stopped paying attention to this question and aren't answering us.
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Hi Jannie, I'd be happy to help. Claims will stay in the Accepted state until SimplePractice receives an electronic Payment Report to update the claims status, or until you manually add an insurance payment. You can enroll in Payment Reports under My Account > Settings > Insurance - Payment Reports automatically record the payment from the insurance payer and allocate the payment to claimed sessions. You can also manually add payments from insurance payers using the paper EOB you received from the payer under Billing > Insurance > Add Payment.
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So these responses are somewhat helpful, but I have received the "Needs Entity Code (20)" in 2 instances with UHC where the claims have been DENIED (not rejected not accepted statuses). Any help with this? What does UHC want me to provide in edited claim? And why now when previous claims have been paid and were generated in exactly the same manner by SP?
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