Secondary claim rejected when sent electronically for missing CAS/COB information

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Jonathan Alldredge

April 08, 2015 20:45

Claims are rejected with the following response 

Acknowledgement/Rejected for Missing Information-Coordination of Benefits Code (ERROR- COB claim balancing failed Total charge amount (ClAIM AMOUNT (CLM02)) 361 does not equal sum of paid amount (AMT02 in OTHER SUBSCRIBER INFORMATION (LOOP 2320)) and all adjustment amounts (CAS in 2320 and 2430). Please correct and resubmit., ERROR DATA- C)

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  GW - Technical Writer April 09, 2015 21:54

  This is the response from the insurance carrier indicating that the AMT*D line (primary payment) Does not match the total of the amounts in the CAS segment. These claim adjustments are part of the HIPAA 5010. Currently, the office needs to arrange an alternative means of submission. In cases of BCBS payors, this will be through the availity portal or through an alternately established means, such as a fax. We do not directly interface with the carriers.

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