Claim Rejections

Submitter not approved

Rejection: Acknowledgement Rejected for relational field in error. Submitter Submitter not approved for electronic claim submissions on behalf of this entity.

What happened: Sent claims to payer, but pre-enrollment is not set up on the payers end.

Resolution: Verify the claim was sent to the correct payer. Verify the NPI in box 33a and if word has been received from the payer about pre-enrollment being completed (see attached picture below).

payer name.jpg|billing npi (hcfa).jpg