Claim Rejections

Medicaid AR MCDAR - authorization/certification number

Rejection: Acknowledgement/Returned as unprocessable claim | Entity not found. | Entitys authorization/certification number.

What happened: The prior authorization number in box 23 was not sent.

Resolution: Based on the CPT code\modifier being billed, the prior authorization is required. Add the prior authorization number in box 23 and resend the claim (see attached picture below).

prior authorization number.jpg