Scroll

eClaims - Common Rejections - COB Claim Balancing Failed/Adjudication Date

Secondary Claim/No EOB Information
Rejection Messages:

  • COB claim balancing failed. Total charge amount does not equal sum of paid amount and all adjustment amounts. (Bad Data: XX )
  • COB service line balancing failed. Charge amount does not equal sum of paid amount and all line adjustment amounts. (Bad Data: XX )

This rejection combination is indicative of a secondary claim. For a secondary claim to correctly process, EOB information from the primary payer needs to be included on the claim; even if the primary paid 0.00. There are usually a couple of things that will flag this rejection. Most notably would be not having 'Use EOB Columns' checked on the Primary Payment. It is also possible that more than one payment is tied to the charges causing the calculations to be off.

Please see Creating Secondary eClaims, for assistance with secondary eClaim creation.

Secondary Claim - Adjudication/Date Claim Paid
Rejection Messages:

  • COB claim balancing failed. Total charge amount does not equal sum of paid amount and all adjustment amounts. (Bad Data: XX )
  • COB service line balancing failed. Charge amount does not equal sum of paid amount and all line adjustment amounts. (Bad Data: XX )
  • LINE LEVEL ADJUDICATION - DATE CLAIM PAID IS MISSING OR INVALID.MUST BE IN CCYYMMD FORMAT.
  • Emdeon Reject LINE LEVEL ADJUSTMENT - OTHER PAYER LINE LEVEL ADJUSTMENT IS MISSING OR INVALID.

This rejection is also indicative of a secondary claim. The third rejection response, ‘Adjudication - Date Claim Paid’, refers to the payment date from the primary payer.

This means that either the secondary claim was created without a primary payment or that there is more than one payment tied one or more charges on the claim. eClaims only pull one date for payment onto an individual procedure line. Because of this, there is not a way to show multiple payments on any charge of a claim. To resolve this, unapply all but one payment. If there are multiple payments on the primary claim, it is best to enter them in one payment window. In the case of 0.00 payments, you can either delete the payment entirely or open the payment and delete all of the ‘0.00 payments’ from the payment column to unapply.

Was this article helpful?
0 out of 0 found this helpful

Comments