Payer Claim Rejection Messages

  Explanation of columns:

  Best Practice for using this TABLE:

  CPID/Payer ID: Unique ID included within a claim to identify the payer
  Step 1. Filter based upon your claim rejection’s associated Payer ID
  Step 2. Filter by Claim Status Category Code
  Step 3. Filter by Claim Status Code
  Step 4. Filter by Entity Code (if applicable)

  Sorting Data: Data can be sorted by clicking the column header

  Filtering Data: Data can be filtered by using the search fields at the top
  of the table. Filters can be cleared by clicking the "⋮" icon at the top of
  the table. 

  The data in the table below is refreshed each week to reflect the
  most current information available
  Claim Status Category Code: X12 code indicating category of the status of
  a claim
  Claim Status Code: X12 code identifying the status of a claim
  Entity Code: X12 Entity Identifier Code used to identify an entity
  Resolution: Change Healthcare propriety description with clarification and
  common next steps to expedite/resolve a payer claim rejection

: The resolution provided may not be inclusive of all claim billing scenarios associated with the Category, Status and Entity Codes. 
  Please ensure your billing scenario meets the corresponding resolution.


For further discussion about this table with your peers and Optum experts, please post in the RCM COMMUNITY DISCUSSION


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