Knowledgebase: Claim Rejections
SECONDARY PAYER RELATIONSHIP TO INSURED
Posted by Will Morrow, Last modified by Charmagne Williams on 12 May 2017 03:39 PM
Rejection: WHEN THE SECONDARY PAYER RELATIONSHIP TO INSURED = SELF, THE SECONDARY INSURED A ND PATIENT NAMES MUST BE THE SAME

What happened: The individual relationship for both the primary and other insured were both sent as "self", but the names were not exactly the same (boxes 2 and 9 HCFA).

Resolution: Need to update the patient name to be exactly the same in both boxes or update the individual relationship code for either the primary or other subscriber as necessary.