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Beacon Health Strategies (43324) Taxonomy Rejections
Posted by Will Morrow on 01 March 2017 04:58 PM
Office Ally is aware of an issue that caused claims to fail for Beacon Health Strategies (43324) with the following message:

Clinician Taxonomy Missing or Invalid

This issue has been resolved as of 2/14.  All affected claims need to be resubmitted for processing.

Any further questions, please reach out to our Customer Service department either via chat, email ( or phone (360-975-7000 opt 1).
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Blue Cross Community Options IL (66005) Taxonomy Rejections
Posted by Will Morrow on 24 January 2017 05:52 PM
Between 1/17/2017-1/24/2017some claims for Blue Cross Community Options IL (66005) may have failed for the following reason:

The provider information segment (loop 2000A, PRV) must be submitted because the provider's taxonomy code impacts adjudication.

The error message is referring to the billing provider taxonomy code.  There was an issue that affected the submission of the billing provider taxonomy code for this payer only that has been resolved.

All affected claims that do contain a billing provider taxonomy code need to be resent.  No changes are needed to the claim.  Simply open the claim in Claim Fix, scroll to the bottom, and click "Update".  That will resend the claim.

If you have any further questions, please contact our customer service department via our chat below, by email (, or by phone (360)-975-7000 opt 1.
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Aetna Provider eSolutions Communication


January 3, 2017


Aetna would like to advise of issues they are experiencing with claims containing terminated and new Home Health procedure codes.


Effective January 1, 2017, the Centers for Medicare and Medicaid Services (CMS) implemented a procedure code change for Home Health providers to distinguish whether a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) provided Hospice or Home Health services. Procedure codes G0163 and G0164 were terminated on December 31, 2016, and they were replaced with G0493 and G0495 (for RN services) and G0494 and G0496 (for LPN services). 

Home health claims are submitted with 60 day episodes. Aetna is incorrectly rejecting claims with both the terminated and new codes submitted on the same claim.  The following error message will be posted to affected claims:

PAYER RESPONSE: Acknowledgement Rejected for Invalid Information - The claim encounter has invalid information as specified in the Status details and has been rejected. HCPCS

Aetna will run daily reports to identify affected claims and manually enter these claims into their system. Therefore, there is no need to resubmit rejected claims that fall under these specific criteria. 


Aetna will handle these claims manually.  Claims fitting this exact criteria can be removed from Claim Fix.

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Erroreous Rejections Multiple Payers 11/7/2016
Posted by Will Morrow on 07 November 2016 10:51 AM
On 11/7/2016the following error messages were reported back erroneously:

Claim Filing Indicator Code should not be used after mandated use of National PlanID. Element SBR09 is used. It should not be used after National PlanID is mandated. Segment SBR is defined in the guideline at position 0050.

National PlanID is a required identifier when it is mandated for use. Value of element NM108 is incorrect. Expected value is 'XV' when National PlanID is mandated for use. Segment NM1 is defined in the guideline at position 0150.

All affected claims have an additional message posted:

Previous rejection messages are erroneous, claims can be removed from Claim Fix

These claims have already been reprocessed, no action needed.  Claims can be removed from Claim Fix.
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Providence Health Plan and 837 claims rejecting in error
Posted by Will Morrow on 12 October 2016 10:59 AM

Providence Health Plans has identified an issue with claims denying for new diagnosis codes starting with date of service 10/01/16.  They have identified the root cause and are currently working on it.  The fix will be in production on Wednesday 10/12/16.

You do not need to resubmit the rejected claims.  They are able to recover the claims and process.  The rejected claims will be processed on Wednesday 10/12/16.

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