Wednesday, September 17, 2008

How to fix CH 64 Invalid Carrier CPID Number

If you are billing through RelayHealth you may stumble across exclusions for a CH 64 invalid Carrier Direct CPID Number in my case 4301. If you are unsure of how to fix this exclusion please read the steps below:

Edit: CH 64 Invalid Carrier Direct CPID # 1350, 4303, 4301, 4302, 4300, 1391CO
Fix: EDI Agreements are not setup between your insurance carrier and RelayHealth
Recommendation: Contact correct party (some clients go through their practice management software while others can contact RelayHealth directly) to identify the status of your EDI Agreement. If no EDI Agreement is on file complete one through RelayHealth's website.
Why CPID# changed: You were probably billing with the Correct CPID# but RelayHealth could not identify the EDI Agreement and was forced to kick out the claims so they convert the CPID# to paper as to not send it electronically.

This situation actually happens extremely often for new clients just getting on board with RelayHealth or as they add new providers to their offices they forget to complete the EDI Agreements.

Claims do not need to be rebilled as corrected claims since they were never forwarded on to the insurance carrier to begin with but denied at the clearinghouse level.

Key Words: EDI Agreements, claim denial, denial code 64, exclusion, electronic claim, medical billing, how to fix, how to resolve, rebill claims, RelayHealth, Clearinghouse, New provider setup, billing medical provider claims, claim exclusion, CPID, Paper CPID, Electronic CPID, improper claim submission, invalid information, clean claim submission

No comments:

Post a Comment