Knowledgebase: Claim Rejections
Regence BS WA 00932 - Other Entity's Adjudication
Posted by Will Morrow, Last modified by Charmagne Williams on 24 May 2017 01:55 PM
Rejection: Acknowledgement/Returned as unprocessable claim | Other Entity's Adjudication or Payment/Remittance Date. Note: An Entity code is required to identify the Other Payer Entity, i.e. primary, secondary.

What happened: Medicare was the primary and a secondary claim was sent within the first 30 days of the Medicare remittance.

Resolution: As of 6/1/13 Regence put an edit in place to not allow a secondary claim where Medicare was the primary until it has been at least 30 days from the date of the Medicare remittance. Need to wait to send the claim until after 30 days of the Medicare remit date.