Returned Claims
Please correct “returned” claims promptly because only when this is done will a provider have met his legal obligation for submitting a Medicare claim.
Definitions
Unprocessable Claim – Any claim with incomplete or missing required information, or any claim that contains complete and necessary information; however, the information provided is invalid. Such information may either be required for all claims or required conditionally.
Incomplete Information – Missing, required or conditional information on a claim (e.g., no National Provider Identifier (NPI)).
Invalid Information – Complete required or conditional information on a claim that is illogical or incorrect (e.g., incorrect NPI) or no longer in effect (e.g., an expired number).
Please correct “returned” claims promptly because only when this is done will a provider have met his legal obligation for submitting a Medicare claim.
Definitions
Unprocessable Claim – Any claim with incomplete or missing required information, or any claim that contains complete and necessary information; however, the information provided is invalid. Such information may either be required for all claims or required conditionally.
Incomplete Information – Missing, required or conditional information on a claim (e.g., no National Provider Identifier (NPI)).
Invalid Information – Complete required or conditional information on a claim that is illogical or incorrect (e.g., incorrect NPI) or no longer in effect (e.g., an expired number).
