Claim received with an unknown provider

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lifelinechiropractic
Posts: 1
Joined: Thu Oct 16, 2014 4:09 pm

Claim received with an unknown provider

Post by lifelinechiropractic » Thu Oct 16, 2014 4:36 pm

I use APEX as my clearinghouse and have used them for several years now. About two weeks ago I started to see that some of the claims I was submitting came back as "Failed". The message was that the Claim was received with an unknown provider and to please select a provider on the form. Some went successfully through and others failed. Now almost all of the claims I submit fail and I have to go and manually enter the provider. I have changed nothing in Medisoft so I am wondering why this is happening. Specifically it is box 33 that is coming up blank on some of the forms but when I compare the information in the Medisoft system with another person whose claim went through successfully I can find no difference. Any idea what is going on? And if not, can you tell me what the fee would be to call in and talk with one of your tech people. We purchased the software through your company and had the free two month support but that has expired now. Thanks for any help you can provide.

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Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: Claim received with an unknown provider

Post by Gavin Walker » Fri Oct 17, 2014 11:22 am

My guess is either your provider ids grid or practice ids grid is not setup right. Setup individual id on provider grid and group id on the practice grid and then select whether you want to file the claim as a group or individual. We can schedule some time for a trainer to go through this with you. It will probably take about an hour or $125.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

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