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Medicaid EDI

Posted: Fri Feb 14, 2020 4:09 am
by meromero2007
Hi Gavin,
I sent some claims electronically to TMHP Medicaid & all of them were rejected to me for this reason:
PERFORMING PROVIDER NPI/API TO TPI COMBINATION OR NPI/API INFORMATION IS INVALID. (01603)
and I called Medicaid EDI help disk they said that i have to add our rendering provider address in loop 2310B segment ref.so please can you help me how can I solve this issue

Re: Medicaid EDI

Posted: Fri Feb 14, 2020 9:07 am
by Gavin Walker
My guess is you need to file the claim to Medicaid as an individual instead of a group. I made this YouTube video where I demonstrate how to setup the provider NPI grids in Medisoft.

Re: Medicaid EDI

Posted: Fri Feb 14, 2020 10:21 am
by meromero2007
they need me to add the address not the NPI or any IDS in loop 2310B segment ref

Re: Medicaid EDI

Posted: Mon Feb 17, 2020 3:27 pm
by Gavin Walker
What clearinghouse are you using or are you sending these direct to Medicaid?

Re: Medicaid EDI

Posted: Sat Feb 29, 2020 4:33 am
by meromero2007
EDIINSIGHT V1.41.2

Re: Medicaid EDI

Posted: Mon Mar 09, 2020 8:48 am
by Gavin Walker
Edit the provider's record and make sure his address is the one you have on file with Medicaid. The provider IDs grid needs to be setup with his Individual NPI and the record for Medicaid needs to be setup to file the claim as an Individual.