Knowledgebase: Claim Rejections
CIGNA (ALL) - Patient eligibility
Posted by Will Morrow, Last modified by Charmagne Williams on 22 May 2017 11:48 AM

Rejection: Rejected - Invalid Data Patient eligibility not found with entity.

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

Resolution: Verify insured ID, patient name, and date of birth, as well as verify if they are the primary insured or a dependent.  If this has been verified already then this is possibly just a member that needs to be updated on the EDI end. This process can take up to 4-6 weeks for update. If the patient information on the claim has been verified to be correct, please contact our customer support department (360-975-7000 opt 1) to have a ticket created at the payer.