This article is for dentists and oral surgeons caring for our members
Periodically, we’ll bring you important information to help you improve the way we work together . The table below explains some common reasons why claims are rejected. It shows the Provider Detail Advisory/Provider Voucher messages you’ll receive for each and best practices for how to resolve the problem.
When the rejection code and message is | This means that | And you should |
---|---|---|
U301: According to our records, we have already processed a claim for this service. Please check your records for a previous claim submission. | We have more than one claim on file for this patient for this service. |
|
M020: The benefit dollar maximum has been reached. | The member has spent all the available dollars for their policy | You can bill the member up to the plan allowable fee for services until their new plan year |
E240: Policy not active for the date of service. Please verify prefix and identification number and resubmit your claim. | The member did not have insurance with us at time of service | Confirm that you submitted the correct information on the claim. If the information was:
|
Log in for access to secure resources.
Dental Blue Book()
CDT Coding Guidelines()
Sample Provider Detail Advisory
To verify claims payment and search for claims, refer to payspan.com.
To verify benefits, eligibility, and claim status, use an eTool like Dental Connect().
MPC_031120-1L-7