Problem: Middle Initial missing in box 31, 32 or 33 or electronic equivalent, Provider, Facility or Clinic Correction: Remove blank before middle init or middle name of provider.
Problem: Last Name, First Name list in the Patient Screen of PBClinic does not always show the
Names in the correct First Name Order.
Correction: Bring up the patient in the patient screen, and delete any blanks that appear at the
Beginning or End of the Last and First Name, then save the changes.
Problem: Loop 1000A NM108, NM109 missing and are required
Correction: If Medicare - Medicare Electronic Submitter Id is missing - get from Medicare
If NOT Medicare - Electronic Transmitter Identification Number (ETIN) from
AVAILITY is missing - Get from AVAILITY - To put in PBClinic see
PayerGroups\InsuranceCompany\Click Here to Set Electronic Claims and Payer Ids\Clinc
or Provider Tab\ Field 1000A_NM108_IdentificationCodeQualifer
Problem: Loop 1000A Segment NM1 Element 8, Element 8 (Identification Code Qualifer is missing)
Correction: Electronic Claims CHC5010, see Field 1000A_NM108_IdentificationCodeQualifer - missing
Most likely should be 46. In the case of Medicare or any Insurance company assigning a
Electronic Submitter Id, then see PayerGroups\InsuranceCompany\Click Here to Set Electronic
Claims and Payer Ids\Clinc or Provider Tab\ Field 1000A_NM108_IdentificationCodeQualifer
Problem: Loop 2000A, If either PRV02 or PRV03 is present then …..
Correction: Administration\Tables\Providers - Add or correct the Taxonomy code
Problem: Loop2010AA, Ref segment should not be used when using NPI
Correction: Got to: Administration\Tables\PayerGroups\insurance company\Click Here to Set Electronic
Claims\ Provider IDS tab\Remove Provider Identifier and Provider Identifier Qualifier - from the
Provider on the claim(s) being rejected.(This assumes you have Pay To Provider? set to Yes)
Problem: Loop2010AA, Value of N403 is incorrect, Expected value for Zip Code is 9 digits
Correction: Add Zip Plus 4 to Clinic and Provider address (mailing and physical) Also
add Zip Plus 4 to boxes 31 and 33.
Problem: Loop2010BA NM109 is incorrect. It should be different than SBR03
Correction: 2010BA NM109 is HCFA Field1A-Insureds ID. SBR03 is HCFA Field 11-Insureds
Policy or Group. They cannot be the same (blank out Field 11)
Problem: Loop2010AA Element N402 is missing. It is required when N404 is not used.
Correction: Run utility to fix missing state (under PBClinic\Administration\Utilities)
Problem: Loop 2010AA, Loop 2310C
Element NM109 is used. It is not expected to be used when it is the same value as element NM109 in Loop 2010AA,
Explanation: Loop 2310C (Service Facility Location) is the same as your office location in Loop
2010AA (Clinic or Provider).
