Claim rejection
AnsweredOptima Claim rejection message, "wrong R name/DOB sent is invalid (21). Called Optima and verified that I submitted same name/DOB as on file. They had not received the claim so I guess SP scrubbed?? Any help greatly appreciated.
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I am getting this rejection notice:
Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. (A3) claim[service_lines][0][procedure_code] has data errors. Parameter claim[service_lines][0][procedure_code] has an invalid code value (21).
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acknowledgment/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. (A3) Missing or invalid information. R CLAIM LEVEL COB INFORMATION INVALID; CLAIM TOTAL CHARGE MINUS CLAIM ADJUSTMENT AMOUNTS MUST EQUAL PAYER PAID AMOUNT WHEN LINE LEVEL ADJUDICATION IS NOT PRESENT FOR THAT PAYER (21)
This was a secondary claim. Where and how do I enter a line level adjudication?
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WI Medicaid keeps rejecting the claim of my 14 year old client. When I call them they tell me that it's because my 3rd Party Biller (Simple Practice) keeps inputting his mother's name instead of the child's name. This causes error code
0614 FIRST NAME DOES NOT MATCH MEMBER ID. Help? How can we get Simple Practice to submit the correct name. Everything is correct on my end --- his name is in the correct field and I have the correct Medicaid Member ID number.
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Hi Margaret, I'd be happy to help. Check to ensure that you have all the fields filled out for the client's insurance under Edit > Billing and Insurance, including the patient's relationship to the insured. If you continue to experience issues, we'd be happy to help - just reach out to our team directly through the ? bubble and we can investigate.
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