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eClaims - Common Rejections - Missing/Invalid Zip Code

Missing/Invalid Zip Code (Subscriber, Patient, Payer)
Rejection messages include, but are not limited to:

  • Reject OTHER PAYER SUBSCRIBER ZIP CODE IS MISSING OR IS NOT A VALID USPS ZIP CODE
  • Reject SUBSCRIBER ZIP CODE IS MISSING OR IS NOT A VALID USPS ZIP CODE, WITHOUT PUNCTUATION (Bad Data: 11472 )

This rejection is stating that there is a zip code that was sent on the claim that is invalid. This could reflect the zip code for the patient, guarantor, or primary/secondary payer. It is important to check each of these fields in MacPractice to be sure that the correct zip code is entered. You will find the fields on the Primary/Secondary/Patient tabs of the patient ability as well as the insurance reference for each payer on the account.
Note: If there is a plan set for the patient there is an additional 'demographics' tab under the plan tab in the insurance reference that will need to be altered.

For zip code verification, please utilize the zip code search tool provided by the United States Postal Service at Zip Code Lookup.

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