Prefix for Entity's Contract/Member Number

Rejection Message

Prefix for Entity's Contract/Member Number

Rejection Details

This rejection indicates that the prefix submitted for the patient’s insurance policy number is invalid or missing. There  are three possible causes:

1. The claim was submitted to the wrong payer ID.
   Note: This is the most likely cause if this rejection was received on claims for multiple patients.
2. The patient’s demographics or insurance policy included on the claim was not eligible for the date of service billed.
3. The patient is a newborn or recently added to the guarantor’s insurance policy.

Resolution

Resolution steps will vary depending on the cause:

1. If the claim is submitted to the wrong payer ID, verify and edit the payer ID.
2. If the patient demographics or policy is incorrect, verify the patient's eligibility.
3. If the patient is a newborn or recently added to the guarantor’s insurance policy, please contact the payer to verify the patient is active under the insured’s policy.

When all corrective actions are completed, rebill and resubmit all affected claims.