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Intellect™

999 ERRORS AND SOLUTIONS

As of 02-02-2012, edits have been organized by loop number and clearinghouse.
New additions continue to show the date they were added.

Change Healthcare (formerly Capario) Rejections

ENS Rejections

TriZetto (formerly Gateway) Rejections

CTX*SITUATIONAL TRIGGER*NM1

Solution: This indicates that your Group NPI and Individual NPI is the same. Go to Utility/Provider and set the <Group Y/N> field to N. Correct this as follows: 

* Intellect (Windows version): Go to Utility/Provider and set the <Group Y/N> field to N.

* OnStaff (Unix version): Go to Utility/Provider and set the <Box24K(Y/N)> field to N.   

IK3 2010:

IK3*N4*11111*2010*8

Solution: This is related to the NDC set up. Please follow the set up instructions:

* For Intellect, click here.

* For OnStaff 2000, click

Once the corrections are made to the procedure, the charges have to be deleted and reposted. The changes ARE NOT retroactive.

IK3 2310:

Added 02-02-2012

Solution: Verify the referring’s NPI against the bad one listed, xxxxxxxxx. Turns out the last digit was wrong.

IK3-PRV-2310

Solution: When the IK4 is populated with the Taxonomy Code, update the system to the latest version.

IK3-SITUATIONAL TRIGGER-NM1-2310

Solution: This rejection is related to the referring provider information. Because of the different type of billings, please contact Medicare directly for direction.

IK3 2310 + CTX SITUATIONAL TRIGGER 2010:

Added 02-02-2012

Solution:

* INTELLECT:

If /Provider/<Group NPI>  =<NPI> set <Group Provider(Y/N)>=N
If /Provider/<Group NPI>^=<NPI> set <Group Provider(Y/N)>=Y

* UNIX:

If /Provider/<Group NPI>   =<NPI> set <HCFA Box 24K(Y/N)>=N
If /Provider/<Group NPI>^=<NPI> set <HCFA Box 24K(Y/N)>=Y

IK3 2320:

CTX*SITUATIONAL TRIGGER***2320 IK3*SBR*55*2320*8

Solution: For Intellect, make sure the Claim Filing Indicator is set to the proper value in the Utility/Insurance table.
Note: When you receive this message, your claims are NOT accepted.

IK3-SBR-2320 Situational Trigger

Solution: This issue can be related to several items. We suggest the following:
Go to Patient Demographics and check Insurance Information as follows:

* Subscriber Number must be a valid Sub ID and Group Number must be a valid Group number (this is especially true for the MEDI-MEDI patients).

* Status field must be blank.   

Added 01-19-2012

IK3*SBR*line#*2320*8

CTX*CLM01:acct#

IK4*3**1

Solution: This is related to the COBA/OCNA Codes. Go to  www.cms.gov/cobagreement/downloads/contacts.pdf and get the 'Identification Number' for the payor.   

* For Unix: Go to Utility/Insurance and populate the <COBA>, <Payor & Office Code>, <Receiver Code>, <GS03>, and <Eligibility Receiver> fields with the 'Identification Number'.

* For Intellect: Go to Utility/Insurance and populate the <COBA>, <Payor & Office Code>, <Receiver>, and <Payer Identifier> fields with the 'Identification Number'.  

IK3 2320 + IK3 2330:

Added 02-02-2012

Solution:

* UNIX –

1) Patient had two ‘T’ertiary insurances. Client may only have one each of Primary, Secondary, &/or Tertiary.

2) Secondary and Tertiary insurances need /Ins/<COBA>, <Payor & Office Code>, <Receiver Code>, <GS03>, <Eligibility Receiver> filled in with the ‘Identification Number’ from the following website:  www.cms.gov/cobagreement/downloads/contacts.pdf.

* INTELLECT - Fields are <COBA>, <Payor & Office Code>, <Receiver>, and<Payer Identifier>.

CTX SITUATIONAL TRIGGER 2320 + IK3 SBR 2320:

Added 02-02-2012

Solution: UNIX - If the Secondary insurance is a Federal Program the patient insurance screen for the secondary insurance needs the <Status> field filled in.

Added 02-02-2012

** I10=Implementation “Not Used” Data Element Present, ‘1’= the bad data

Solution: Charge posted with no diagnosis yet <RDX>=1 so eitheradd diagnosis or ste <RDX>=blank

IK3 2330:

CTX*SITUATIONAL TRIGGER*N4*681*2330*4

N4 usually indicates a zip code error.

2330 indicates the ANSI 5010 Loop.

The account number is located in the CTX:CLM01 line. For example:

• Intellect: CTX:CLM01:1.0002837: 1 represents the clinic#, 2837 the pt acct number

• OnStaff 2000: CTX:CLM01:0002837 represents the pt acct number

Solution: Check the zip code for the insurance, making sure that it matches the city and state.

IK3=NM1-2330

Solution: This issue is related to special characters in the Utility/Insurance/Name. 5010 does not allow special characters. Go to Utility/Insurance/Modify and remove all special characters.  

Added 02-02-2012

Solution:

UNIX -  The /Ins/<Address>

‘1234 HAPPY RD ATTN:CLAIMS’  is invalid.

Remove the ‘ATTN:CLAIMS’ and rebill.

NOTE: These special characters may NOT be used:

‘~’, ‘*’, ‘:’.

IK3 2400:

Added 02-02-2012

PROBLEM: Wrong modifier. Must be 2 characters

SOLUTION: Fix and resubmit

Added 02-02-2012

   -OR-

Problem: Wrong diagnosis pointer:

• 2 diagnoses posted yet 3 indicated in <RDX>

-or-

• 3 diagnoses posted with diagnosis 1 and diagnosis 3 the same and <RDX>=123 so either delete the third and set <RDX>=12 or just change <RDX> to ‘12’.

Solution: Fix and resubmit

Change Healthcare (formerly Capario) Rejections

Added 02-02-2012

[ACKNOWLEDGEMENT/RETURNED AS UNPROCESSABLE CLAIM]

[Element SBR05 is missing. It is required when SBR01 is not ‘P’ and payer]

[is Medicare.]

Solution:

Whenever Medicare is ‘S’econdary , Patient Insurance <Status> is required

ENS Rejections

Added 02-02-2012

Rejection Code:H20658

Rejection Descr: Segment REF exceeded HIPAA max use count.

Segment Cnt: Loop: 2010AA Element: 0 Sub Element:  0

Solution:

* INT - Set /Insurance/<NPI Support>      = X

* UNIX - Set /Insurance/<NPI(Y/N/P/X)>  = X

Added 02-02-2012

The client receives the following on the  â€˜ELECTRONIC RESPONSE REPORT’, e.g.,

TRICARE – West Region ELECTRONIC RESPONSE REPORT:

CLAIM STATUS: [ERR CODE:           A3   21   Acknowledgement/Returned as]

CLAIM STATUS: [unprocessable claim-The claim/0000000000]

Solution:

Client does nothing. ENS resubmits the claim for the client. The client then waits 2-3 days for

an updated ‘ELECTRONIC RESPONSE REPORT’ without this error.

Added 02-02-2012 

Acknowledgement / Rejected for relational field in error

Submitter not approved for electronic claim submissions on behalf of this entity.

Solution:

This is a problem that occurred at Palmetto and the claim(s) needs to be resubmitted.

TRIZETTO (formerly GATEWAY) Rejections

Added 02-02-2012

***4010 Claims Only***

Validation error – Extra data was encountered. DTP segment could not be validated due to unrecognized d’.

Solution:

This is something GW had a problem with at their end and have worked it out.

Please rebill the claims.

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