Claim Rejections

Providence Health Plan PHP01 - Invalid Insured ID Format (RC129)

Rejection: Payer Specific Edit: Invalid Insured ID Format. Must be 11 characters starting with 100, OR 10 characters starting with 2 letters, OR 9 characters starting with R. Last 2 characters must be numeric. (RC129)

What happened: The insured ID in box 1a does not fit the following criteria:

11 digits starting with 100,101,111,112 and the last two digits cannot be greater than 15 OR

10 characters starting with two letters ending in two zeros (00) OR

9 characters starting with R and last 2 characters must be numeric.

Resolution: Verify the patient's insured ID and update box 1a as necessary (see attached picture below).

insured id (hcfa).jpg