To remain in compliance with Medicaid billing requirements, on December 14, we’re moving to up-front claims rejections that have the missing or incorrect information listed below. Previously these were warnings.
The new upfront rejections included:
- Claim Type Requires a Referring/Ordering NPI
- Provider Type Not Allowed for Referring/Ordering/Attending NPI
- Claim Not Covered When Referring/Ordering/Attending is Chiropractor
- Referring/Ordering/Attending is not Enrollment Type 1/Individual
In addition, all claims must be submitted in the appropriate format or they will also receive an up-front rejection.