VALIDATION ERRORS. No 6 Service not selected A Service must be selected on the Form. No 7 Billing Provider must have a Tax ID

Transcription

1 1 Client not selected A Client must be selected on the Form. 2 Worker not selected A Worker must be selected on the Form. 3 Billing Provider not selected A Provider must be selected on the Form or on the Automated Service (for event tracking). 4 Location not selected A Location must be selected on the Form or on the Automated Service (for event tracking). 5 Start Date or Start Time not selected A Start date and Start Time must be entered on the Form. 6 Service not selected A Service must be selected on the Form. 7 Billing Provider must have a Tax ID A Billing Provider Tax ID must be entered on the Provider tool. 8 Date of Birth not entered on the Client Basic Date of Birth was not entered for the client on the Information Client Basic Information. 9 Gender not selected on the Client Basic Gender was not selected for the client on the Client Information Basic Information. The Client has no Payers or no Payers with Active and 10 active Client Payer exists Inactive Dates that are inclusive of the Start Date of the Service. 11 Policy Number is missing or invalid on Client Payer(s) On any Client Payer, a Policy Number must be entered with at least 2 characters and it cannot contain spaces. 12 Billing Provider Address is missing or is not in the United States The Billing Provider for this Service must have a primary address with United States selected as the country. 13 The Policy Holder's name must exist for the Client Policy Holder Name is missing on Client Payer Payer. 14 ICD-9 Diagnosis unavailable for Date of ICD-9 Diagnosis exists on or before the Start Date of Service the Service. 15 Service t Billable On the Service tool, this service is marked as "no" for "Is this Service Billable?". authorization could be found for this service 16 appropriate Authorizations are available because: (1) units are remaining (2) Date of Service is outside the authorized range (3) Authorization was found for this Payer 20 Number of Billable Units missing on te One or more Services on the Form does not have any Units 21 Patient Relationship to Insured is missing on On the Client Payer, the Patient Relationship to Insured Client Payer is not selected. 28 Policy Holder Address missing on Client Payer or is not in the United States The Policy Holder's Address must exist for the Client Payer with United States selected as the country. 29 Policy Holder Date of Birth missing on Client Payer 30 Policy Holder Gender missing on Client Payer The Policy Holder's Date of Birth must exist for the Client Payer. The Policy Holder's Gender must exist for the Client Payer. Page 1 of 6

2 33 Additional Same Day Service(s) Failed to Validate This client had additional Service(s) on the same day that failed to validate. This Service will not validate until all additional same day services for this client are either resolved or are no longer marked billable. 34 This Service Overlaps with Another Service for the Same Client The Start or End Date/Time for this Form or the event tracking overlaps with one or more Billable Form(s) for the same Client and the Service does not Allow Overlap. 41 Client Gender Must be "Male" or "Female" 42 Billing Provider Number Type is missing 43 Billing Provider NPI Number is missing 44 Rendering Provider NPI Number is missing 47 Rendering Provider Number Type is missing 48 Payer Address is missing or is not in the United States A Gender of "Male" or "Female" must be selected on the Client Basic Information or Client Payer. On the Provider Payer Tab of a Billing Provider, if a On the Provider Payer Tab of a Billing Provider, if "Use Only NPI" is checked then an NPI Number must be On the Provider Payer Tab of a Rendering Provider, if "Use Only NPI" is checked then an NPI Number must be On the Provider Payer Tab of a Rendering Provider, if a On the Payers Tool, Contact Info Tab, a primary Address must exist or a Payer Address must be selected on the Client Payer. The Address must also have United States selected as the country. 49 Payer Type is missing On the Payers Tool, a Payer Type 54 Date of Service cannot occur in the future 55 Billable Minutes exceed duration on te Client Date of Birth must be before the Date of Service Policy Holder's Date of Birth must be before the Date of Service The Start/End Date entered on the Form cannot occur in the future. For Duration-Based services, the number of minutes entered on the Service cannot be more than the amount of time between the Start and End Time on the note. The Date of Birth entered on the Client Basic Information must be before the Date of Service. The Policy Holder's Date of Birth entered on the Client Payer must be before the Date of Service. 69 EB: Billing Provider Postal Code must be 9 digits The primary Address on the Billing Provider must contain a 9-digit Postal Code for electronic billing. Page 2 of 6

3 73 Authorization number cannot be all zeros The Client Authorization Number cannot be all zeros. 74 Rendering Provider is missing 75 Bill Hold Period has not Elapsed On the Fee Schedule, for this Payer, this Service is marked "yes" for "Requires Rendering Provider", but a Rendering Provider was not selected on the Form or on the Automated Service (for event tracking). This bill is on hold until the Number of Bill Hold Days specified on the preferences tool has elapsed from the Date of Service. 96 EB: Group Number and Policy Number cannot match On the Client Payer, the Policy Number and Group Number cannot match for electronic billing. 106 Client Date of Birth and Policy Holder Date of Birth Cannot Match If the Patient Relationship to Insured specified on the Client Payer is "19 - Child", then the Policy Holder's DOB entered on the Client Payer cannot be the same as the Client's DOB entered on Client Basic Information. 115 Maximum Number of Units Exceeded This Service has a Number of Units greater than the Maximum Number of Units allowed in a specified period of time according to the Fee Schedule. 116 Billing Format is missing 117 Fee Schedule is missing 118 Billing Credential is missing on Worker 119 EB: Billing Provider primary Contact is missing EB: Billing Provider primary Contact Phone Number is missing EB: Billing Provider Primary Address is missing 122 End Date or End Time not selected 123 Unit Duration not specified on Fee Schedule On the Payer Tool, a Billing Format must be specified and have the same line of business as selected on the Fee Schedule or Coding Rule. On the Fee Schedule for this Payer, the Service could not be found or the Fee Schedule is not active for this Date of Service. Billing Credential Category must be selected on Staff/Professional Employment tab. The Billing Provider for this Service must have a primary Contact for electronic billing. The Billing Provider s primary contact must have a Phone Number for electronic billing. The Billing Provider s primary Contact must have an Address for electronic billing. An End Date and End Time must be entered on the Form. For Duration-Based services, the Fee Schedule Must have Unit Information completed. 124 Pay-To Address must be in United States On the Providers Tool, Contact Information Tab for the Billing Provider, the Address of Type Pay-To must contain an address with United States as the Country. Page 3 of 6

4 125 Location Address must be in the United States On the Location Tool, Contact Information Tab, the Address must have United States as the Country. 126 Coding Rule Conditions not met Rendering Provider is missing the Payer for this client Billing Provider is missing the Payer for this client 129 Ordering Provider NPI Number is missing 130 Ordering Provider Number Type is missing 131 Ordering Provider is missing 132 Ordering Provider is missing the Payer for this client 133 Referring Provider NPI Number is missing On the Fee Schedule for this Payer, this Service is marked as "Coding Rules Required" but none of the Coding Rule Conditions have been met. On the Rendering Provider's Payer tab, the client's Payer must be present. On the Billing Provider's Payer tab, the client's Payer must be present. On the Provider Payer Tab of an Ordering Provider, if "Use Only NPI" is checked then an NPI Number must be On the Provider Payer Tab of an Ordering Provider, if a On the Fee Schedule, for this Payer, this Service is marked "yes" for "Requires Ordering Provider", but an Ordering Provider was not selected for this Service on the Form. On the Ordering Provider's Payer tab, the client's Payer must be present. On the Provider Payer Tab of a Referring Provider, if "Use Only NPI" is checked then an NPI Number must be 134 Referring Provider Number Type is missing On the Provider Payer Tab of a Referring Provider, if a 135 Referring Provider is missing the Payer for On the Referring Provider's Payer tab, the client's Payer this client must be present. 136 Duplicate Billable te This note is a duplicate of another billable note. 137 ICD-10 or DSM 5 Diagnosis unavailable for ICD-10 or DSM 5 Diagnosis exists on or before the Date of Service Start Date of the Service. 138 Location Address is missing. On the Location tool, a primary Address is required for this payer. 139 A change has occurred to the Client Tracking for this client that has impacted this Bill A change has occurred to the Client Tracking for this client that has impacted this Bill. To resolve this error, it may be necessary to Remove and Add this Event again. 140 EB: Billing Provider Address cannot be a PO Box The primary Address on the Billing Provider cannot be a PO Box for electronic billing. 141 te Requires Additional Signature(s) Additional Electronic Signature(s) must be on the Form. Page 4 of 6

5 An Add-On Service must have a corresponding Base Service on the same day NCCI: A Conflicting Procedure Code has been Detected for this Client on the Same Day 144 Pass Thru Payer exists 145 Billing Code Type Must be HCPCS/CPT for this Billing Format 146 Postal code not valid for U.S. 147 A Revenue Code must exist for this Billing Format This is an Add-On Service and it must have a corresponding Base Service in order to be reimbursable. Another billable service on this client is missing. Another note exists that has an NCCI edit that cannot be overridden by attaching a modifier. This indicates that two procedures cannot be performed in conjunction. An add-on service may be appropriate on one of the notes. additional client payers were found for this client that accept pass thru billing. This Service must have a Billing Code Type of HCPCS/CPT specified on the Services tool when using a Billing Format of 1500 or 837P. On the Payer Tool, the Payer's postal code is not valid for the US. This Service must have a Revenue Code specified on the Services tool when using a Billing Format of UB04 or 837I. 148 Billing Provider First Name is invalid 149 Facility Type must exist for this Billing Format 150 Attending Provider is missing 151 Admitting Diagnosis is missing 152 Referring Provider is missing 153 Client's Self-Pay Payer is incomplete 154 Location Address requires a 9-digit zip code 155 Relationship to Insured must be 18 - Self for the payer 156 te entered beyond the time period allowed by the Fee Schedule for this Service. This Billing Provider used for this service cannot have a first name when using a Billing Format of UB04 or 837I. On the Location tool, a Facility Type must be selected when using a Billing Format of UB04 or 837I. On the Placement Event for this client, an Attending Provider must be selected under the Billing Information section. On the Referral or Request Event for this client, an Initial Diagnosis On the Fee Schedule, for this Payer, this Service is marked "yes" for "Requires Referring Provider", but a Referring Provider was not selected for this Service. On the Client Basic Info> Payer tab, the Self-Pay payer contains incomplete address information. The primary location address entered on the location tool must have a 9 digit zip code. On the client payer tool, the selected patient relationship to insured must be 18 Self for the Payer. The billable note must be entered within the number of days indicated on the Fee Schedule for this Payer and Service. Page 5 of 6

6 te entered beyond the time period The billable note must be entered within the number of 157 allowed by the Payer. days indicated on the Payer. Page 6 of 6