Our claim number for the duplicate claim should be shown in the comment at the bottom of our explanation of benefits (EOB). Our payment system determined that this claim is an exact match of a claim that we previously processed. Top 10 Reasons Family Member Program Claims are Rejected or Denied Top 10 Reasons Family Member Program Claims are Rejected or Denied
Invalid Service line Provider Taxonomy code Must be a valid street address.Ĭlaim contains one or more missing/incomplete/invalid/inappropriate "Place of Service" codes. Missing/Invalid Admission Date for POS 21 Refer to Box 18 Missing Insurance Plan Name or Program Name Requires the 17 alpha-numeric internal control number (ICN) or 9-digit social security number (SSN) with no special characters. The following are the most common reasons HCFA and UB paper claims for Veteran care are rejected: Top reasons for HCFA/CMS-1500 rejections Top Reasons for HCFA/CMS-1500 Rejections Top 10 Rejection Reasons for Veteran Care If an error is identified during this scan, the provider will receive a letter from VA with information about the error and reason for rejection. During the conversion process, if a claim has been found non-compliant with standardized billing requirements, the claim will be rejected until the error is corrected. When VA receives a paper claim, it is reviewed for errors twice: once during electronic conversion and again during claims processing.
VA requires all paper claims to be converted to 837 electronic submissions. Rejections During the Electronic Conversion Process
VA classifies all processed claims as accepted, denied, or rejected.