Rejection: Rejected - Invalid Data Entity not eligible for benefits for submitted dates of service.
What happened: Based on the patient information the claim, the patient was not eligible for benefits on the date of service.
Resolution: Verify insured ID, patient name, and date of birth, as well as verify if they are the primary insured or a dependent?(see attached picture below). If this has been verified already then this is possibly just a member that needs to be updated on the EDI end. This process can take up to 4-6 weeks for update. If the patient information on the claim has been verified to be correct, please obtain proof of eligibility and?contact our customer support department (360-975-7000 opt 1)?to have a ticket created at the payer.
