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BCBS Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. (A3) Missing or invalid information. (21).

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Heather Scarboro

All of the practice's claims for BCBS where rejected with this error message.  Nothing has changed!  Please help! I can't find any errors in client/practice/provider info.

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12 comments

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  • Sarah Reynolds

    I am having the same issue! I put in a help ticket 20 hours ago and have not gotten any responses.

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  • Heather Scarboro

    Oh man!  I wonder if it's a clearinghouse issue?

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  • Sarah Reynolds

    That's what I'm thinking it might be. I hope so!

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  • Sherry Mason

    Am having the same issue with all of my BCBS claims that I submitted a few hours ago. I have submitted a ticket so hoping for a response soon!

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  • Heather Scarboro

    This was an email response I received to my service ticket.  Completing now and hoping this is the fix. Also, how petty of BCBS!

    Hi Heather,
     
    I've reviewed this claim and see the rejection message "Missing or invalid information."
     
    Our clearinghouse has notified me that the insurance payer, Blue Cross Blue Shield of North Carolina (NCBLS), noted that any claims received after 08/02/22 after 10:00 PM EST will be rejected when the Service facility location information (Box 32) and Billing Provider information (Box 33) are the same.
     
    Moving forward, our clearinghouse has recommended to leave Box 32 (Service facility location information) blank if the information matches Box 33 (Billing Provider information).
     
    To do this, please go to your Settings > Billing & Services > Insurance page. Here, under Service Facility Location (Box 32), please uncheck the box for "Include on Claim Form." When updated, click Save.
     
    For these rejected claims, you can delete the claims and create new claims to submit to the insurance payer.
     
    You can first download copies of the original claims and note the Clearinghouse Reference #s and the Payer Claim #s, if available. You can store these for your records for instances regarding timely claim filing. For more information, please visit our Help Center guide here: Storing client documents.
     
    Then you can delete the claims by clicking on the trash can icon on the claim forms and recreate new ones with the dates of service to ensure that the updated information is properly pulled from the client's page onto the claim forms.
     
    Please let me know if you have any other questions, and I'll be happy to help you.
     
    Best,

    Alan A.
    Insurance Specialist
    Pronouns: she/her/hers

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  • Sarah Reynolds

    Thank you for the information, Heather. I have still not received a response from SP customer service for my ticket.

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  • Heather Scarboro

    I'm so sorry Sarah!

    So far, the claims haven't been rejected yet.. so maybe this is the fix.

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  • Kit Wood

    I have received the rejection "Missing or invalid information. R ACK/RETURNED - PAYER RESPONSIBILITY SEQUENCE NUMBER CODE - INSURED OR SUBSCRIBER".please tell me what to do and how we can resolved?

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  • Veronica Aparicio
    Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system. (A3) Missing or invalid information. VALUE OF SUB-ELEMENT COMPOSITE MEDICAL PROCEDURE IDENTIFIER-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - HCPCS CODE (130) WHEN COMPOSITE MEDICAL PROCEDURE IDENTIFIER-01='HC'. PROFESSIONAL SERVICE IS DEFINED IN THE GUIDELINE AT POSITION 3700. (21).
    • Missing or invalid information. VALUE OF SUB-ELEMENT COMPOSITE MEDICAL PROCEDURE IDENTIFIER-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - HCPCS CODE (130) WHEN COMPOSITE MEDICAL PROCEDURE IDENTIFIER-01='HC'. PROFESSIONAL SERVICE IS DEFINED IN THE GUIDELINE AT POSITION 3700.
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  • Shiray Sondrup

    I have resubmitted based on the above information Heather received 3 months ago from the insurance specialist. I am stumped. Hopefully this will help. One clients claims- keeps being rejected over and over. ugh. Any other info on the subject would be greatly appreciated. 

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  • Erik Newman

    Has this issue been solved? My contract with BCBSNC went active at the beginning of December. I jus submitted my first set of claims, and I'm getting this same message for all of them.

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  • Susanna Aich

    What can I do to resolve this rejected claim:

    -The claim/encounter has been rejected and has not been entered into the adjudication system. (A3) Missing or invalid information. VALUE OF SUB-ELEMENT HEALTH CARE CODE INFORMATION-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - ICD-10-CM DIAGNOSIS CODE (897) WHEN HEALTH CARE CODE INFORMATION-01='ABF'. HEALTH CARE INFORMATION CODES IS DEFINED IN THE GUIDELINE AT POSITION 2310. (21).

    • Missing or invalid information. VALUE OF SUB-ELEMENT HEALTH CARE CODE INFORMATION-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - ICD-10-CM DIAGNOSIS CODE (897) WHEN HEALTH CARE CODE INFORMATION-01='ABF'. HEALTH CARE INFORMATION CODES IS DEFINED IN THE GUIDELINE AT POSITION 2310.
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