Carelon MD billing rejections

Follow

Amber Schmidt

• June 30, 2025 21:36

Hello everyone,

I am not sure why I am only allowed to post in the note and form template exchange but I will give it a try. 

I’m reaching out because my claims to Carelon are being rejected with the following message:
“It has not been entered into the adjudication system. Entity's primary identifier – this code requires an entity code (A3-755).”

I’m honestly feeling overwhelmed. Carelon is already significantly behind on payments, and I haven’t been able to submit any claims for weeks. Managing this transition has taken hours of my time, and I'm desperate for a path forward or at least some clarity.

I do have a private message thread open with SimplePractice, and I’m hoping for answers soon. Their latest update was:

“We understand the urgency of this issue, and the clearinghouse continues to follow up with the payer with requests of escalation. Once the payer shares more information with the clearinghouse, we will let you know of those updates.”

If anyone has experienced this issue—or has any insight into what might be going on—I would be incredibly grateful to hear your thoughts.

1

• 

  Lisa Burke

  • July 01, 2025 15:50

  I just encountered the same issue. Any insight would be very helpful. Thank you in advance. 

  0

  Comment actions Permalink
• 

  Savannah Stone

  • July 08, 2025 19:13

  I recently received this message about a claim and trying to get support from SP has been a complete nightmare. It is very disappointing. I would love to know how to navigate this. 

  0

  Comment actions Permalink

Please sign in to leave a comment.