When a claim is submitted electronically, it can be rejected if any errors are detected or if there's any incorrect or invalid information that doesn't match what's on file with the payer. This means the claim needs to be submitted with the correct information before it can be processed.
This error comes from the payer when there is an issue with the claim, however, the payer does not specify what those errors are. In cases like this, it is recommended to review your claim for any discrepancies such as the spelling of the patient’s name, date of birth, member ID number, and any details about the services rendered on the claim.
If you are unable to determine the issue with the claim, reach out to the payer to speak with the EDI department directly. When speaking with the payer, have them pull up the rejected claim and explain why the claim is rejected.
Once the session has been corrected, resubmit the claim back to the payer.