Acknowledgement/Rejected For Missing Information Entity’s Tax ID. Rendering Provider

Rejection Details

Claim is getting rejected due to one of the following reasons:

1) Group NPI and rendering NPI is same. Individual NPI must be added in provider’s profile instead of group NPI.
2) Rendering provider’s NPI is invalid
3) Rendering Provider is not credentialed
4) On plan page in settings module, ‘Not Allowed’ is selected for Rendering Provider under Miscellaneous due to which Rendering Provider loop is not populating in EDI file.

Resolution

Use the following workflows according to the reasons:

Reason 1 & 2:

• Go to Settings > Practice > Provider > Practice Provider 
• Click on Provider Name
• Correct the NPI and save the profile page

Reason 3:

• Kindly contact the relevant insurance and complete the credentialing process for the provider

Reason 4:

• Go to Settings > Billing > Plan
• Search the plan name and click on it
• Click on Miscellaneous to expand the options
• Select the “Rendering Provider” option as “Situational”
• Save and resubmit the claim.