When you generate claims from Billing -> Generate Claims, some may not get transmitted and instead the claim will be put in the status = "Generation Errored" You can then look at the Claim Status history and hover your mouse over the cell for Claim Error and it will give you one the following Loop / Segment / Error Message combinations. You can then refer to the "How to Fix in EMR" column to see how to correct these.
Loop |
Segment |
Error Message |
How to Fix in EMR |
|
---|---|---|---|---|
2000A |
PRV - Billing Provider Specialty Information |
"PRV01", "The value must equal 'BI'" |
Contact ReLiMed Support, this indicates the Billing Provider is not identified properly |
|
2000A |
PRV - Billing Provider Specialty Information |
"PRV02", "The value must equal 'PXC'" |
Contact ReLiMed Support, this indicates the Billing Provider Taxonomy Code is not identified properly |
|
2000A |
PRV - Billing Provider Specialty Information |
"PRV03", "A valid non-null, non-empty value is expected." |
Admin -> Location -> Billing sub tab should have a valid Taxonomy Code listed. However, if the Payor Entry has an override of the Billing Provider, for example, you bill under an individual Provider, then you must check the Admin -> Personnel Entry for that Provider and make sure there is a valid Taxonomy Code on the Provider Info tab |
|
2000A |
CUR - Foreign Currency Information |
"CUR01", "The value must equal '85'" |
Contact ReLiMed Support, this indicates the Billing Provider Currency is not identified properly |
|
2000A |
CUR - Foreign Currency Information |
"CUR02", "A valid non-null, non-empty value is expected." |
Contact ReLiMed Support, this indicates the Billing Provider Currency is not identified properly |
|
2010AA |
NM1 - Billing Provider Name |
"NM101", "A valid code is expected." |
Contact ReLiMed Support, this indicates the Billing Provider Name is not identified properly |
|
2010AA |
NM1 - Billing Provider Name |
"NM102", "A valid code is expected." |
Contact ReLiMed Support, this indicates the Billing Provider Entity Type is not identified properly |
|
2010AA |
NM1 - Billing Provider Name |
"NM103", "A valid non-null, non-empty value is expected." |
Make sure Billing Provider Last Name (if an individual provider) or Organization Name is entered and valid which would be Admin -> Location Name or Admin -> Personnel Entry -> Provider Last Name |
|
2010AA |
NM1 - Billing Provider Name |
"NM109", "When NM108 is provided, a valid non-null, non-empty value is expected." |
Make sure Billing Provider NPI (if an individual provider) or Organization NPI is entered and valid which would be Admin -> Location NPI or Admin -> Personnel Entry -> Provider NPI located on the Provider Info sub tab |
|
2010AA |
N3 - Billing Provider Address |
"N301", "A valid non-null, non-empty value is expected." |
Make sure Billing Provider Street 1 (and optionally Street 2) address is entered and valid which would be Admin -> Location Address. When individual provider is used as an override, we still populate this from Location Address |
|
2010AA |
N4 - Billing Provider City, State, Zip Code |
"N401", "A valid non-null, non-empty value is expected." |
Make sure Billing Provider City, State and Zip +4 under address is entered and valid which would be Admin -> Location Address. When individual provider is used as an override, we still populate this from Location Address |
|
2010AA |
REF - Billing Provider Tax Identification Number |
"REF01", "A valid code is expected." |
Contact ReLiMed Support, this indicates the Billing Provider Tax ID is not identified properly |
|
2010AA |
REF - Billing Provider Tax Identification Number |
"REF02", "A valid non-null, non-empty value is expected." |
Make sure Billing Provider Tax ID/SSN (if an individual provider) or Organization Tax ID is entered and valid which would be Admin -> Location, Billing sub tab and Tax ID or Admin -> Personnel Entry -> Provider Tax ID/SSN located on the Provider Info sub tab |
|
2010AA |
REF - Billing Provider UPIN / License Information |
REF01", "A valid code is expected." Or "REF02", "A valid non-null, non-empty value is expected.")); |
If you are populating Billing Provider State LIcense or Provider UPIN License, make sure it is a valid/non empty value |
|
2010AA |
PER - Billing Provider Contact Information |
"PER01", "A valid code is expected." Or “PER03", "The value must equal 'EM', 'FX' or 'TE'" |
Contact ReLiMed Support, this indicates the Billing Contact is not identified properly |
|
2010AA |
PER - Billing Provider Contact Information |
"PER04", "A valid non-null, non-empty value is expected.")); |
Make sure you have a Billing Contact with at least Phone populated on Admin -> Location and Billing sub tab |
|
2010AB |
NM1 - Pay-To Address Name |
"NM101", "A valid code is expected." Or “NM102", "A valid code is expected." |
Contact ReLiMed Support, this indicates the Remit To Address Name is not identified properly |
|
2010AB |
N3 - Pay-To Address - Address |
N301", "A valid non-null, non-empty value is expected." |
If you have a different Remit-To address (Most commonly a PO Box) then make sure to have an address entered on Admin -> Location switching Address type to “Billing”. This is Street 1 and optionally Street 2 |
|
2010AB |
N4 - Pay-To Address City, State, Zip Code |
"N401", "A valid non-null, non-empty value is expected." |
If you have a different Remit-To address (Most commonly a PO Box) then make sure to have an address entered on Admin -> Location switching Address type to “Billing”. This is City, State and Zip |
|
2010AC |
NM1 - Pay-To Plan Name |
"NM101", "A valid code is expected." Or ", "NM102", "A valid code is expected." |
Contact ReLiMed Support, this indicates the Payor Name is not identified properly |
|
2010AC |
NM1 - Pay-To Plan Name |
"NM103", "A valid non-null, non-empty value is expected.")); |
Make sure you have a Payor Name populated accurately for this claim, from Admin -> Billing -> Payor Entry |
|
2010AC |
NM1 - Pay-To Plan Name |
"NM108", "A valid code is expected.") or "NM109", "A valid non-null, non-empty value is expected." |
Make sure the Payor ID (EDI Payor ID) is populated accurately for this Payor, from Admin -> Billing -> Payor Entry |
|
2010AC |
N3 - Pay-To Plan Address |
"N301", "A valid non-null, non-empty value is expected." |
Make sure you have an Address (Street 1 and optionally Street 2) for this Payor, from Admin -> Billing -> Payor Entry |
|
2010AC |
N4 - Pay-To Plan City, State, Zip Code |
"N401", "A valid non-null, non-empty value is expected." |
Make sure you have an Address with City, State, and Zip code for this Payor, from Admin -> Billing -> Payor Entry |
|
2010AC |
REF - Pay-To Plan Secondary Identification |
"REF01", "A valid code is expected." Or “REF02", "A valid non-null, non-empty value is expected." |
This is a secondary ID for the payor, NOT USED AT THIS TIME |
|
2010AC |
REF - Pay-To Plan Tax Identification Number |
"REF01", "A valid code is expected." Or "REF02", "A valid non-null, non-empty value is expected." |
This is the Tax ID for the payor, NOT USED AT THIS TIME |
|
2010BA |
NM1 - Subscriber Name |
"NM101", "A valid code is expected.” Or "NM102", "A valid code is expected." |
Contact ReLiMed Support, this indicates the Policy Holder Name is not identified properly |
|
2010BA |
NM1 - Subscriber Name |
"NM103", "A valid non-null, non-empty value is expected." |
Make sure the Policy Holder Name is entered properly from Patient Info -> Insurance, select Insurance record and then Policy Holder tab |
|
2010BA |
NM1 - Subscriber Name |
"NM108", "The code must equal 'II' or 'MI'" or "NM109", "A valid non-null, non-empty value is expected." |
Make sure the Policy Number is entered properly from Patient Info -> Insurance, select Insurance record and check Policy Number field |
|
2010BA |
N3 - Subscriber Address |
"N301", "A valid non-null, non-empty value is expected." |
Make sure you have an Address (Street 1 and optionally Street 2) for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab |
|
2010BA |
N4 - Subscriber City, State, Zip Code |
"N401", "The subscriber's city is required." |
Make sure you have an Address with City for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab |
|
2010BA |
N4 - Subscriber City, State, Zip Code |
"N402", "The subscriber's state is required." |
Make sure you have an Address with State for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab |
|
2010BA |
N4 - Subscriber City, State, Zip Code |
"N403", "The subscriber's zip code is required (must be 5 or 9 digits)." |
Make sure you have an Address with a valid Zip code for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab |
|
2010BA |
N4 - Subscriber City, State, Zip Code |
"When the subscriber's relationship is 'self, the N4 element (Subscriber City, State, Zip Code) is expected.")); |
Make sure you have an Address with City, State, and Zip code for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab |
|
2010BA |
DMG - Subscriber Demographic Information |
"DMG01", "A valid code is expected." or "DMG02", "A valid date is expected." |
Make sure you have a Date of Birth entered for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab OR if the patient is the Policy Holder, on Patient Info -> Demographics |
|
2010BA |
DMG - Subscriber Demographic Information |
"DMG03", "A valid code is expected." |
Make sure you have a Gender entered for this Policy Holder, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab OR if the patient is the Policy Holder, on Patient Info -> Demographics |
|
2010BA |
REF - Subscriber Secondary Information |
"REF01", "A valid code is required.” Or "REF02", "A valid identifier is required.” |
If entering an SSN for the patient, make sure this information is entered correctly, from Patient Info -> Insurance, select Insurance record and then Policy Holder tab OR if the patient is the Policy Holder, on Patient Info -> Demographics |
|
2010BA |
REF - Property and Casualty Claim Number |
"REF01", "A valid code is required." Or "REF02", "A valid identifier is required." |
Check Agency Claim Num entered on Claim Override tab for Accident/Worker’s Comp for valid format |
|
2010BA |
PER - Property and Casualty Subscriber Contact Information |
PER01", "A valid code is expected." Or "PER03", "A valid code is expected." Or "PER04", "A valid communication number is expected." |
NOT USED AT THIS TIME |
|
2010CA |
NM1 - Patient Name |
"NM1", "", "The NM1 element (Patient Name) is expected." |
Patient Last Name is required, check Patient Demographics |
|
2010CA |
N3 - Patient Address |
"N301", "The patient's address is required.” |
Check the Patient’s Address (Street 1 and optionally Street 2) on Patient Info -> Demographics |
|
2010CA |
N4 - Patient City, State, Zip Code |
"N401", "The patient's city is required." |
Check the Patient’s Address for City on Patient Info -> Demographics |
|
2010CA |
N4 - Patient City, State, Zip Code |
"N402", "The patient's state is required.” |
Check the Patient’s Address for State on Patient Info -> Demographics |
|
2010CA |
N4 - Patient City, State, Zip Code |
"N403", "The patient's zip code is required (must be 5 or 9 digits)." |
Check the Patient’s Address for Zip code on Patient Info -> Demographics |
|
2300 |
CLM - Claim Information |
"CLM01", "The patient control number (claim identifier) is required" |
Contact ReLiMed Support, this indicates the Claim Number has not been generated properly |
|
2300 |
CLM - Claim Information |
"CLM02", "The total claim charge amount must be greater than or equal to zero" |
Check claim total charges amount from Billing -> Edit Claims |
|
2300 |
CLM - Claim Information |
"CLM05", "The place of service code is required", "CLM05-01" or “CLM05", "The place of service code qualifier is required |
Check claim for Place of Service (Billing Facility) selected from Billing -> Edit Claims |
|
2300 |
CLM - Claim Information |
"CLM05", "The claim frequency code is required" |
Check claim for Claim Frequency Code from Billing -> Edit Claims, then Rebills/COB tab, must be not selected for new claim or a selection from the list |
|
2300 |
CLM - Claim Information |
"CLM05", "When the 'Claim Rebill/Correction Code' is 'Rebill' or 'Void', then the 'Payer Claim Control Number' must be present." |
Check claim for Claim Frequency Code from Billing -> Edit Claims, then Rebills/COB tab, when it is a “Replacement..” or “Void..” then the Payer Claim Control Number must be populated |
|
2300 |
DTP - Date - Statement |
“DTP01”, "A valid non-null, non-empty value is expected for Statement date" |
Check Start Date and End Date of encounter for this claim from Edit Claims |
|
2300 |
CL1- Institutional Claim |
"CL103", "A valid non-null, non-empty value is expected for Patient Discharge Status" |
For Institutional Claims Only: Check for selected Patient Discharge Status on Edit Claims, UC-04 tab |
|
2300 |
HI - Health Care Diagnosis Code |
"The HI element (Health Care Diagnosis Code) is expected.") |
Make sure there id at least one Diagnosis code added to the encounter and selected on the line items from Edit Claims; Diag PTRs pop-up. **NOTE: the Diagnosis Number selected MUST be from 1-12. Only 12 go on the claim |
|
2310A |
NM1 - Attending Provider Name |
"NM109", "The attending provider identifier (NPI number) is required." |
NOT USED AT THIS TIME |
|
2310B |
NM1 - Rendering Provider Name |
"NM109", "The rendering provider identifier (NPI number) is required." |
Make sure the Provider on the encounter has an NPI populated under Personnel -> Provider Info. This can also be seen from Edit Claims, Referral/Authorization tab |
|
2320 |
AMT - Coordination of Benefits (COB) Payer Paid Amount |
"AMT", "The COB payor paid amount is required." |
For Secondary Claims, this amount must be there and equal to the total amount paid by the Primary/previous payor. Check this amount from Edit Claims, Rebills/COB tab “Payor Paid Amt” **NOTE the Payor ID must match the Primary/previous payor ID on the line item override pop-up |
|
2400 |
SV1 - Professional Service |
"SV107", "The first diagnosis code pointer must be specified." |
This line item MUST have at least one diagnosis PTR from Edit Claims; Diag PTRs pop-up. . **NOTE: the Diagnosis Number selected MUST be from 1-12. Only 12 go on the claim |
|
2400 |
SV1 - Professional Service |
"SV102", "The COB line item totals do not balance." |
For Secondary Claims, each line item totals must balance: Total charges – Previously Paid - Adjustment – Remaining Pt Liability = $0. Additionally, the total Amount Paid from Primary/previous Payor from each line item must match the total paid for the claim on Rebills/COB tab for Payor Paid Amt |
|
2410 |
CTP - Drug Quantity |
"CTP04", "The quantity must be greated than zero.” |
The Quantity must be specified with NDC code for any drugs. Check CPT Code Entry for the particular CT code OR line item Overrides pop-up for the three fields |
|
2410 |
CTP - Drug Quantity |
"CTP05", "The unit of measure code qualifier must be specified." |
The Quantity must be specified with NDC code for any drugs. Check CPT Code Entry for the particular CT code OR line item Overrides pop-up for the three fields |
|
2430 |
SVD - Line Adjudication Information |
The 'Other Payer Primary Identifier' must contain a valid ID |
For Secondary Claims, make sure the Payor ID of the Primary/previous payor matches the one on the claim level Rebills/COB tab and is valid |
|
2430 |
SVD - Line Adjudication Information |
A line adjustment requires a line payment. |
For Secondary Claims, make sure the Primary Payment amount plus valid Remittance date is populated on the line item Overrides pop-up. |
|
2430 |
DTP - Line Check or Remittance Date |
The payment date is required |
For Secondary Claims: Check for the Remittance date on the Line Item Overrides pop-up |