Common Clearinghouse Rejections

1) Rendering Provider Loop (2310B) is missing: The insurance company that you are submitting to is telling you that your claims need to have a rendering provider.

What do I need to do to fix this?
• You will need add a rendering NPI name and number to the client’s profile, via client → edit info.

2) Invalid Unit Counts: You have 0 units entered for the service line

What do I need to do to fix this?
• You will need to determine the reason why your claim has 0 units. Have you completed the correct amount of billable time for this service? Has the service been canceled off the calendar? Once you have determined the issue and adjusted the claim to reflect billable units, you can resubmit the claim.

3) Facility code invalid: The payer is referring to the place of service code that you indicated on claim.

What do I need to do to fix this?
• Confirm you have the correct location selected for the service that is being performed. If this needs updating, please contact us for support.

4) Rendering provider secondary identification is missing: This claim was rejected during a claim error check at the clearinghouse. One of the secondary identifiers on your claim is missing.

You will commonly see this for Tricare claims.
What do I need to do to fix this?
• Confirm you have the correct providers NPI, SSN and/or License number entered on the servicing employees’ profile.
 
5) This code requires the use of an Entity Code. Insured/Subscriber: There are many reasons why you may be getting this error. Typically, with this error the payer cannot find the insured/subscriber.

What do I need to do to fix this?
• Confirm you have the correct subscriber/policy holder information entered in insurance numbers.
• Contact the payer to get additional information/confirm subscriber number, name and DOB.
• Check the payer portal for eligibility.

6) Provider not enabled for non-commercial payer: The submission of claims requires completion of additional registration steps prior to actual processing (EDI enrollment). Claims will not be sent to these payers electronically until the electronic registration is approved.

What do I need to do to fix this?
• Make sure you have completed all EDI enrollment forms prior to submitting claims through the clearinghouse

7) Subscriber Primary ID# Must be 9-11 Digits: The subscriber ID# is incorrect.

Member pick reject: The payer cannot find the member ID.

What do I need to do to fix this?
• Confirm the patient’s subscriber number and correct in client edit info and insurance numbers.

8) Invalid NPI: NPI is incorrect

What do I need to do to fix this?
• Confirm the providers NPI number and correct on employee edit info. If NPI is listed as a rendering NPI you will also need to update on client edit info and resubmit the claim.