Claim Rejection: NM109 Missing or Invalid Rendering Provider (TheraNest)

  Permissions: You must have Billing Permissions with the ability to "submit Claims to Clearinghouse" enabled.

Claim Rejection:

• RENDERING PROVIDER LOOP(2310B) IS MISSING Missing or invalid

This rejection usually indicates the Rendering Provider is missing from the electronic file. To Fix the rejection you must check the rendering provider NPI in the Staff Profile, verify the EDI File Settings and resubmit the claim.

NOTE: The information in the electronic file is controlled by your EDI File Settings. The information on the PDF version of the CMS-1500 might be different than the electronic claim according to these settings. 

Fix Rejection

Check Staff Rendering Provider NPI

1. Click Staff and Active staff membersin the navigation bar.
2. Find the staff that is the provider and click Details.
3. Verify and correct the Provider NPI on the details page.
   
4. Click Save Details.

Verify EDI File Settings for Provider

1. Click Billing tab in primary navigation bar.
2. Click Insurers in side menu.
3. Click Edit for appropriate Insurer.
4. In EDI File Settings, ensure the Rendering Provider is always included in the Electronic Claim. Check boxes 3 & 4.
   
   
   
5. Save changes.
6. You can now resubmit your Claims.

If you have any other questions about EDI File Settings you can check out the article below.

How to Setup EDI File Settings