Knowledgebase: Claim Rejections
ENTITY NOT FOUND. - PROVIDER
Posted by Will Morrow, Last modified by Charmagne Williams on 16 May 2017 02:34 PM
Rejection: ACK/RETURNED - ENTITY NOT FOUND. - PROVIDER

What happened: Some or all of the provider information on the claim (NPI in box 24j or 33a, TIN in box 25, provider name in box 33) (see attached pictures below) is not what the payer has in their system.

Resolution: This is a reply coming directly from the payer. Need to verify how the provider is set up at the payers end (individual vs. rendering, NPI, TIN, etc.). If confirmed that everything is correct, call or chat with our customer service department (360-975-7000 opt 1).


Attachments 
 
 rendering npi.jpg (19.09 KB)
 billing npi (hcfa).jpg (81.35 KB)
 tax id (hcfa).jpg (77.99 KB)
 billing provider name.jpg (39.18 KB)