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Fusion Enterprise

Claim Error: Referring Doctor Invalid NPI

  • Aug 13, 2025 2:35 PM UTC
  • Aug 28, 2025 8:16 PM UTC
  • 0 replies
  • 10 views

Ensora Education Team
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Claim Error:

  • Referring Doctor Invalid NPI

There are two possible fixes for this error.

 

FIX 1: 

Mostly, this can happen if the NPI is not entered or entered incorrectly for a Referring Doctor. Follow these steps to fix:

  1. Right-click on the error and Open Case.
  2. Right-click Open Referring Doctor

    NOTE: this will take you to the Doctors table and the exact Doctor that is linked to the case. Review the NPI and make sure there are no issues such as extra spaces, too many numbers, etc.

  3. Go back to the Case and right-click, select Edit General Info.
  4. Click the X next to Referring Doctor to remove it.
  5. Then click the 3 dots (...) to select the Referring Doctor again and click OK.
  6. Generate Claims again and the error should clear.

 

FIX 2: 

OR, on rare occasions, this can happen if a space gets entered into the Referring Doctor field in the patient's case. In this case, it would appear that the patient did not have a Referring Doctor entered, but the system is reading the space that was entered and looking for further info. Follow these steps to fix:

  1. Right-click on the error and Open Case. 
  2. Right-click Edit General Info.
  3. Click the X next to Referring Doctor and click OK.
  4. Generate Claims again and the error should clear.
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