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Common Rejections - Payer ID

Common Rejections - Payer ID

Missing/Invalid Payer ID

Rejection Message:

  • EDI PROFESSIONAL CLAIMS ARE NOT AVAILABLE FOR THIS PAYER ID (Bad Data: XX )

This rejection is stating that the payer ID that was used on the claim is not a valid payer ID for electronic claims submission through Change Healthcare. The number listed in the rejection next to Bad Data is the ID that prompted the rejection.

To be able to send claims through a clearinghouse, an electronic connection has to be made between the payer and clearinghouse. While each payer has it's own unique payer ID, there are instances when the clearinghouse has a payer ID for that payer that differs from the ID the payer uses. In these instances, claims should be submitted using the clearinghouse payer ID. The clearinghouse will forward the claims to the payer using an outbound payer ID. The person billing the claims will not need to take any additional steps to complete this.

A comprehensive medical payer list can be accessed here. All payer IDs entered in MacPractice need to match the payer ID as it shows in the clearinghouse payer list, even if the payer ID on the payer list differs from the payer ID stated by the payer.

For dental, you can access the payer list here. This list is updated regularly as new payers are added.

If the user is unable to find the desired payer ID, click here to review other options for sending the claim.

 

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