As a provider, you can correct insurance claims that have been rejected for
processing or denied for payment on the Insurance
Claims Needing Attention page. Under "Claiming" on the task bar, select "Workable Claims", and "Insurance".
This Workable Problems report is divided into three tabs: Category 1 - Problems detected by Fiscal Agent, Category 2 - 277 Rejections, and Category 3 - 835 Errors. Please note that each tab
can be exported to Excel by clicking "Excel" at the bottom of the page.
Category 1 - Problems detected by Fiscal Agent
If you scroll to the right, you can more clearly see the error number, error description, and the option to "Edit/Fix Claim"
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Error
#
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Error Description
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Provider
Action
|
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Error 1
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No policy or group # on child
insurance policy
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Fix in NYEIS/KIDS. Once the correct information is available in EIBilling.com, use the "Edit/Fix Claim!" screen to click "Fix" to submit this claim.
|
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Error 2
|
Missing Tax ID
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Contact the Customer Service Center 1-866-315-3747 Monday-Friday 7am-7pm
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Error 3
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Missing Child Address
information
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Fix in NYEIS/KIDS. Once the correct information is available in EIBilling.com, use the "Edit/Fix Claim" screen to click "Fix" to submit this claim.
|
|
Error 4
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Missing/Invalid ICD9 Code
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Click “Edit/Fix Claim” Please check the ICD-9 code with the ICD-9 Code reference list under
"Reports" in the EIBilling.com menu. If an ICD-9 code that is listed as
"Do Not Use" in this report turns out to be appropriate for a claim,
contact Provider Support for further assistance.
|
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Error 5
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Missing/Invalid CPT Code
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Click “Edit/Fix Claim” Please check the CPT code with the CPT Code reference list under
"Reports" in the EIBilling.com menu. If an CPT code that is listed as
"Do Not Use" in this report turns out to be appropriate for a claim,
contact Provider Support for further assistance.
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Error 7
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Invalid Rendering Provider NPI
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Fix in NYEIS/KIDS. Once the correct information is available in EIBilling.com, use the "Fix it!" screen to fix and submit this claim.
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Error 8
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Invalid Therapist Name
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Fix in NYEIS/KIDS. If blank under "Provider Profile" >"Associated Providers", correct in EIBilling and select "False" for NYEIS Updates. If correct in EIBilling, contact Customer Service Center 1-866-315-3747 Monday-Friday 7am-7pm. Once the correct information is available in EIBilling.com, use the "Edit/Fix Claim" screen to fix and submit this claim.
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Error 9
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No Rendering Therapist
Assigned
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Click “Edit/Fix Claim” and select a therapist from the drop-down menu.
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Error 10
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Invalid Billing Provider
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Contact the Customer Service Center at 1-866-315-3747 Monday-Friday 7am-7pm
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You can look up your error number in the table above, and take the appropriate action.
If you would like to fix an ICD-9 Code, CPT Code, correct or add a therapist, or add a delay reason, click "Edit/Fix Claim"
Update the appropriate information and/or add a delay reason, and click "Save Changes and Resubmit Claim".
For all other errors, if you have corrected this error in NYEIS/KIDS and the new information is available on EIBilling.com, you can check the box next to those claims and press "Resubmit" at the bottom.
Once we receive the next NYEIS/KIDS import, you will see the updated therapist information, insurance policy information, child address information, etc available on EIBilling. Check the "Child Lookup" screen for insurance and child information, and the "Associated Provider for Medicaid" tab under your "Provider Profile" for therapist information.
Please note that a delay reason only needs to be entered if it is applicable to that denial code.
Click here for information on correcting Insurance Policy information.Click here for more information on how to check if the IFA has already received your EOB's. Category 2 - 277 RejectionsHere is a Knowledge Base Article with a list of common Insurance 277 Rejections and how to proceed with each rejection.
This Knowledge Base article includes a full list of 277 codes.
If you do not see your rejection listed in the PDF,
please contact the Customer Service Center at 1-866-315-3747 Monday-Friday 7am-7pm.Please note that a delay reason only needs to be entered if it is applicable to that denial code.
Article ID: 86, Created On: 7/3/2013, Modified: 10/28/2015