To streamline the process for resubmitting "clean" claims from a rejected batch/file, the clearinghouse is changing the process for reporting payer batch/file level rejected claims.
The clearinghouse will no longer provide the rejected 999 payer report to identify payer batch/file level rejections. Instead, when the clearinghouse receives a rejected batch/file from a payer, the clearinghouse will automatically resubmit the "clean" claims (those that do not have errors) immediately upon receiving the 999 transaction from the payer (if applicable). We will notify you about claims that rejected on the payer's 997/999 through the FX Report.
For those payers who do not return a report to providers after the initial 999 report to the clearinghouse, we will return the payer 999 report to providers for accepted claims. This will help clarify which claims have been accepted.
This change ensures that clean claims not processed by the payer due to a file level rejection are resubmitted immediately.
Click here to see a list of affected payers
Action Required: Please be aware of this reporting enhancement.
If you have any questions, please contact Client Services at 1-888-348-8457, option 2.