Claim Rejections

Aetna 60054 - Dependent not eligible

Rejection: Acknowledgement Returned as unprocessable claim-The claim encounter has been rejected and has not been entered into the adjudication system. Dependent not eligible.

What happened: Based on the patient information listed on the claim, the patient was not eligible for benefits on the date(s) of service.

Resolution: Need to verify insured ID, patient name, and date of birth, as well as verify if they are the primary insured or a dependent.