It appears that you have the same value entered for the primary ID (Box 1A of the CMS-1500) and for the policy/group number (Box 11 of the CMS-1500).
How to fix
From the error page, click the edit icon next to the insurance card. This will open up the edit insurance card form. On the right, make sure you have the correct values entered for the primary ID (Box 1A) and the policy number (Box 11). If there is no policy number listed on the insurance card, then leave the policy number blank in Therabill.
Once you have edited the insurance card in Therabill and saved your changes. You can then click the Resubmit Electronically button at the top of the error page.
- ELEMENT NM109 IS USED. IT IS NOT EXPECTED TO BE USED WHEN IT HAS THE SAME VALUE AS ELEMENT NM109 IN LOOP 2010AA. SEGMENT NM1 IS DEFINED IN THE GUIDELINE AT POSITION 2500
- Insured Group Policy Number Cannot Equal Insured ID