Medicare Rejections

Tele-Therapeutics · Post by **Tele-Therapeutics** » Thu Jun 07, 2012 1:38 pm

I have been trying to deal with Medicare for quite a while and my claims continue to be rejected.
I have been told that the "rendering provider" is not going through to Medicare. I have printed the claim out to double check myself and in the 1500 form box 24 J it is printing out with rendering provider NPI. However when mapped it is not going through to Medicare on their end. We are using Emdeon and we are certified for ANSI 5010. I am set up "linked" with my group NPI and I am the rendering provider with the same NPI. The info looks good when I print it out, but that is a 1500 form and need to find out if it is mapped differently, am I missing something in Medisoft, do I need to call Emdeon, or is this a Medicare issue? Any help would be appreciated.

Post by **Gavin Walker** » Mon Jun 11, 2012 8:41 am

Without knowing the exact error message you are getting, it is kind of hard to guess, but the rendering provider needs to have the individual NPI and billing provider needs to be the group NPI. One of the most common errors we are hearing about is the 9-digit zip code is missing from the billing provider address. Enter the 9-digit zip without a dash.

Tele-Therapeutics · Post by **Tele-Therapeutics** » Mon Jun 11, 2012 5:28 pm

Thanks for the reply....will try anything at this point.
There is no "error message". This is what I am told by a rep at Medicare. I will try a different NPI as well. (individual vs Group) as rendering and let you know if that makes a difference, but i had tried that before to no avail.

Jennifer · Post by **Jennifer** » Fri Jun 15, 2012 10:17 am

I am also receiving the Medicare rejections in Revenue Management. Just started happening recently.
I konw it is looking for the group NPI, and that NPI is in my practice configuration, but it is not finding it in the claim.

Error reads: info is missing or invalid for Billing Provider Primary ID 2010AA NM109.

I have 3 providers under this group and one is okay, but the other two are not and i just dont get it. I have compared the set up and do not see any differences.

Please help and these claims need to be sent.

Thank you.

Post by **Gavin Walker** » Fri Jun 15, 2012 2:14 pm

And did you enter a 9-digit zip code on your practice address?