Help! Sumbitting claims but being rejected due to "Patient Eligibility not found with Patient"
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I have submitted multiple claims and each one comes back saying "rejected due to patient eligibility not found with patient. Individual received medical care. R acknowledgement/rejected for invalid information-  the claim/encounter has invalid information as specified in the status details and has been rejected."

 

This is my first claim I've submitted and no clue what could possibly be incorrect.

 

Some background info:

This patient is not the primary card holder.  Do I use her husbands ID number in box 1a or do I use her ID number (she has a 02 after the main one). I have also corrected the address she has on file.  Turns out she gave me the wrong address than what is on file with insurance.  Any other info I could be missing? Insurance verifies I have the correct information and has validated eligibility for my services. They don't know why it isn't going through.  It leads me to believe something isn't filled out correctly. 

2 comments

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    Gillian

    Hi Megan, I see that you're working on scheduling a call with our team regarding this soon. We're looking forward to assisting. 

    Hi Megan, I see that you're working on scheduling a call with our team regarding this soon. We're looking forward to assisting. 

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    Sharon McDonnell

    HELLO,

    Will Magellan's info be on the insurance card?  As i am billing i just have Blue Shield, etc and my claims are for mental health.

    thank you

    Carol

    HELLO,

    Will Magellan's info be on the insurance card?  As i am billing i just have Blue Shield, etc and my claims are for mental health.

    thank you

    Carol