Claim Rejection: Status Details - Entity: Insured or Subscriber (IL) (TheraNest)

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

Claim Rejection:

• (A7) The claim/encounter has invalid information as specified in the Status details and has been rejected.,  Status: Entity's contract/member number., Entity: Insured or Subscriber (IL)

Fix Rejection

Payer is rejecting the Claim because the Client Name or Insured/Subscriber ID Number is either incorrect or the Client is no longer eligible.

You will need to ensure that the Client Insurance ID Number and Name listed on their Insurance card matches what in in their Bill To & Insurance Info tab, as well as verify their eligibility with the Payer.

NOTE: Information in their Bill To & Insurance Info tab must match what the Payer has on file for the Client or Claims will not process correctly.

1. Locate Client and open Client Profile.
2. Click Bill To & Insurance tab.
3. Locate appropriate Insurance and click Edit.
4. Update to the Client's new Medicare Number.
5. Click Save.