Periodically we bring you important information to help you avoid having your claims rejected. Below is the second article of three parts that explain some common reasons why claims are rejected and the Provider Detail Advisory/Provider Voucher messages you’ll receive for each. (See the first part here.) We’ve also outlined best practices for how to resolve the problem.
|When the rejection code and message is||This means that||And you should|
|X419: Your NPI and tax ID combination do not match the information we have on file. Please verify the NPI and tax ID and submit a new claim.||We do not have the same NPI and tax identification on file as what you submitted||List the practice NPI in box 49. For sole proprietors, report the individual NPI in box 49. Validate all software programs for the correct information prior to claim resubmitting the claims. Refer to Section 5 of the Blue book for proper billing guidelines.|
|F042: We can't identify the member from the ID number submitted. Please verify eligibility by using online services at Bluecrossma.com/provider (log in required). Please submit a new claim with the correct id number.||We cannot find a member that has insurance with us at time of service||Confirm that the correct information was submitted on the claim. If the information was:
|B415: The patient’s plan does not cover this dental procedure.
E232: This is not a covered benefit.
|The member does not have benefits for this procedure on their policy with us||You may bill the member for service.|