Permissions: You must have Billing Permissions with the ability to "Submit Claims to Clearinghouse" enabled.
Claim Rejection:
- Status Details - Category Code: (A3) The claim/encounter has been rejected and has not been entered into the adjudication system., Status: Entity's National Provider Identifier (NPI), Entity: BillingProvider (85)
Fix Rejection
The Billing Provider Name/NPI is not on file with this Insurance Company. Please verify how you are credentialed with this Insurance. You double check the NPI's that are listed in the system.
Check Group/Organization NPI
- Click Organization tab in primary navigation bar.
- Scroll to bottom of Organization Profile screen and verify Organization NPI.
Check Individual NPI
- Click Staff tab in primary navigation bar.
- Locate appropriate Staff and click Details.
- Verify Provider NPI.
You can update the Billing Provider on the Claim, and then after you've made the corrections, Resubmit the Claim.