Medicaid EDI

General information about Medisoft
Post Reply
meromero2007
Posts: 14
Joined: Sat May 31, 2014 7:53 am

Medicaid EDI

Post by meromero2007 » Fri Feb 14, 2020 4:09 am

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

User avatar
Gavin Walker
Posts: 4391
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Medicaid EDI

Post by Gavin Walker » Fri Feb 14, 2020 9:07 am

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.
Gavin Walker
Walker Tek Solutions, LLC
866-890-6777 x0
417-763-6386

meromero2007
Posts: 14
Joined: Sat May 31, 2014 7:53 am

Re: Medicaid EDI

Post by meromero2007 » Fri Feb 14, 2020 10:21 am

they need me to add the address not the NPI or any IDS in loop 2310B segment ref

User avatar
Gavin Walker
Posts: 4391
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Medicaid EDI

Post by Gavin Walker » Mon Feb 17, 2020 3:27 pm

What clearinghouse are you using or are you sending these direct to Medicaid?

meromero2007
Posts: 14
Joined: Sat May 31, 2014 7:53 am

Re: Medicaid EDI

Post by meromero2007 » Sat Feb 29, 2020 4:33 am

EDIINSIGHT V1.41.2

User avatar
Gavin Walker
Posts: 4391
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Re: Medicaid EDI

Post by Gavin Walker » Mon Mar 09, 2020 8:48 am

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.

Post Reply