Rejected Claim
AnsweredDoes anyone know what the following means:
Acknowledgement/Returned as unprocessable claim-The claim/encounter has been rejected and has not been entered into the adjudication system.
Missing or invalid information. COB CLAIM BALANCING IS FAILED FOR PAYER WITH ID '87726' (IDENTIFICATION CODE IN OTHER PAYER NAME LOOP) TOTAL CHARGE AMOUNT (TOTAL CLAIM AMOUNT) '375.00' DOES NOT EQUAL SUM OF PAID AMOUNT (MONETARY AMOUNT IN OTHER_PAYERS[N] AND ALL ADJUSTMENT AMOUNTS (CAS IN 2320 AND 2430) '175.00'. MONETARY AMOUNT INFORMATION IS DEFINED IN THE GUI Missing or invalid information. COB SERVICE LINE BALANCING IS FAILED CHARGE AMOUNT (LINE ITEM CHARGE AMOUNT) '200.00' DOES NOT EQUAL SUM OF PAID AMOUNT (SERVICE LINE PAID AMOUNT) AND ALL LINE ADJUSTMENT AMOUNTS (CAS) '175.00'. SERVICE LINE ADJUDICATION IS DEFINED IN THE GUIDELINE AT POSITION 5400. Missing or invalid information. COB SERVICE LINE BALANCING IS FAILED CHARGE AMOUNT (LINE ITEM CHARGE AMOUNT) '175.00' DOES NOT EQUAL SUM OF PAID AMOUNT (SERVICE LINE PAID AMOUNT) AND ALL LINE ADJUSTMENT AMOUNTS (CAS) '0.00'. SERVICE LINE ADJUDICATION IS DEFINED IN THE GUIDELINE AT POSITION 5400. Missing or invalid information. MONETARY AMOUNT INFORMATION IS USED. IT SHOULD NOT BE USED WHEN MONETARY AMOUNT INFORMATION IS USED IN OTHER_PAYERS . MONETARY AMOUNT INFORMATION IS DEFINED IN THE GUIDELINE AT POSITION 5505. (A3 - 21)
Post is closed for comments.
Comments
1 comment