The insurance company is rejecting this due to an issue with the post date of the primary insurance payment.
When sending a secondary claim (electronically), the adjudication information (all the payments and adjustments) from primary is sent on the electronic claim in a section called Coordination of Benefits (COB). The post date of the payment/adjustment is part of this Coordination of Benefits information. For some reason, the payer does not like the date of the payment listed for the primary insurance payments.
Things to look for
- Is the post date of the payment in the future?
- Is the post date of the payment prior to the date of service of the charge?
- Is the post date after the date you submitted the claim?
- Did you enter primary insurance adjudication information?
If you need to call the payer to find out more information, make sure you let them know you submitted the claim electronically and that it was EDI rejected. Usually, the adjudication department (the first person you usually talk to) does not have any record of claims that were rejected by their EDI.