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FAQ Page 3
Problem: Loop2300, Value of sub-element CLM05-03 is incorrect. (Claim Frequency Code)
Correction: 1) Check Claim Frequency Code on Claim screen (upper left) 2) HCFA Field 22 -
Original Ref No should have insurance company’s claim number - get it from insurance
company.
Problem: Loop2300, Segment HI, HI01, HI02 etc missing or incorrect
Correction: Invalid diagnosis codes. Correct in ledger, re-bill claim. May need to
correct in Tables\ICD
Problem: Loop 2300 or 2400 - Passing a note
Notes at Claim Level or Service Level
There are two different instances here
If you wish to pass a note that applies to the entire claim then
Put the word ADD plus a space and then the note following it in Field 19 on the HCFA form This will cause whatever is entered in Field 19 to be passed in the Note (NTE2) in Loop 2300
If you are using a CPT which considered Not Otherwise Classified (NOC) then you would either
1) Mark the CPT field IsNOC = yes in the CPT table
or
2) Mark the IsNOC field = yes in the Services Entry or Ledger tab
This will then cause whatever you type in the Service Description field to be passed in
the Note (NTE2) in Loop 2400
Problem: Loop2310A Segment Ref - ‘1B’ not allowed
Correction: Field 17a - Provider Id Qualifer and Provider Id - Do NOT use, delete values
Only NPI should be used
Problem: Loop2310A NM109 is incorrect or missing
Correction: Add or correct the NPI for the ‘Referring’ provider in Administration\Tables\ReferingProviders
Problem: Loop2310B, Ref segment should not be used when using NPI
Correction: Remove Provider Identifier and Provider Identifier Qualifer from Provider
Correction: When the facility HCFA1500 Field 32 is the same as your office, do either A or B.
A) From the Facility drop down list in the Case screen, choose ‘None’ - preferred correction
B) Make the street address of the Facility(HCFA Box 32) the same as the street address in
Box 33 of the HCFA 1500)
Note: After either one of these solutions, you must create a new claim for those service rejected
In order for the corrected Facility, Clinic, Provider information to be included
Problem: Loop 2320 is missing. It is expected to be used when other payers are known to be involved in
paying on this claim (SBR01 is 'S').
Correction: When billing a secondary claim electronically it should be coupled with the primary.
Try creating a new claim for this service(s) make sure you set up both primary and secondary
insurance claims. You can then fake print the primary(just print it to the screen) and then mark the secondary to be billed (ReBill? = Yes).
Problem: :Loop 2320 missing: It is expected to be used when other payers are known to be involved in
paying on this claim (SBR01 is 'T')
Correction: Create a new claim and pay attention to the ‘New Order’ column it should have a value which
indicates the insurance company is 1-Primary or 2-Secondary or 3-Tertiary
Problem: Loop2330B, NM108 or NM109 missing.
Correction: This is most probably a secondary claim being billed electronically and the primary insurance
does not have an electronic payer id setup. If primary is sent on paper, you must still setup
electronic PlanId (PlanId=99999 if none is known) and PlanIdQualifier = PI
Problem: Loop2400, Value of sub-element SV!01-02 is incorrect
Correction: The CPT code is not valid, please investigate and find the correct CPT code.
Problem: The length of Element SBR09 (Claim Filing Indicator Code) is '3'. The maximum allowed
length is '2’
Correction: Tables\PayerGroup\ClaimFilingIndicator, choose correct entry from drop down list,
usually ‘CI’ for Commercial.
Problem: Loop2400-Unrecognized data was found in the data file as part of Loop 2400. The last known
Segment was REF at guideline position 4700.
Correction: A Medicare Secondary claim was created without a primary claim as part of the same
Claim Set.
Create a new claim, mark both the Primary Insurance and Medicare secondary to be billed.
Then faux print the primary to paper, enter a zero payment from the primary if the primary has
already paid or denied. This will then cause the Medicare secondary to release correctly to
electronic and be attached correctly with the primary.
Problem: Loop2400-Unrecognized data was found in the data file as part of Loop 2400. The last known
Segment was REF at guideline position 4700.
Correction: May be caused by using an injection CPT code but not including the Drug Code,
Measurements or amount. Also may need to use NOC field.
Problem: Payment entry - Constraint Failed, Duplicate, Null etc
Correction: Go to Insured’s Screen and if Field 11, Insureds Polity Group.... is empty,
Put a blank in the field and save it. Then re-try payment entry.
Problem: A Data Element With Must Use Status is Missing
Loop 2320, Segment SBR, Element 5
Correction: Field 11c of HCFA 1500 needs to have the type of Medicare Secondary Insurance selected. The patients Medicare Secondary Plan must be setup as the secondary insurance, do not select just Medicare, select one of the Medicare Secondary Plans.