Claim Rejections

Billing and PayTo provider same entity (FE355)

Rejection: Payer edits require the Billing and PayTo provider to be the same entity, containing either the same NPI and/or TaxID (FE355)

What happened: The billing NPI/TIN does not match the Pay-To NPI/TIN.

Resolution: This should be updated in the billing software, but can be updated in claimfix. Update the claim as necessary and update the claim (see attached picture below).

pay-to tax id npi (hcfa).jpg|billing npi (hcfa).jpg