| Reason Code |
Total Claims Returned to Providers during January and February, 2002 |
Type of Error |
Resolution by Provider |
| 30715 |
7,792 |
Billing - patient information |
Check HIQA, if bene info has changed, advise beneficiary to contact SSA to have personal information changes. Claims must be billed to reflect beneficiary information in HIQA, even if the personal information has not been updated by SSA. |
| 19403 |
4,006 |
"Other Physician ID", omitted or invalid |
Educate internal billing staff or vendor. |
| 19401 |
3,987 |
Billing - "Other Physician last name and first initial incorrect or omitted" |
Educate internal billing staff or vendor. |
| 19402 |
3,417 |
Billing - 'Other Physician' UPIN incorrect |
Educate internal billing staff or vendor. |
| 32000 |
2,977 |
Billing - incorrect provider number |
These claims are dropping off the system after 60 days. Providers need to check with their vendors and internal billing staff to ensure provider numbers are keyed correctly. |
| 19301 |
2,280 |
Billing - Operating physician ID, name, first initial and number |
Educate internal billing staff or vendor. |
| 32404 |
2,262 |
HCPC billing error |
Educate internal billing staff or vendor. |
| 38119 |
2,187 |
Sequential billing First claim in a series must finalize before next claim is submitted. |
Educate internal billing staff or vendor. |
| 38118 |
1,308 |
Sequential billing |
Same as above. |
| 15701 |
2,081 |
Billing - Payer ID omitted or incorrect |
Educate internal billing staff or vendor. |
| 12302 |
2,053 |
Billing - number of covered and non-covered days do not equal the number of days in the from and through dates. |
Educate internal billing staff or vendor. |
| Total |
34,350 |
|
|
