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eClaims - Common Rejections - Missing/Invalid Provider Taxonomy

Missing/Invalid Provider Taxonomy
Rejection messages include, but are not limited to:

  • Emdeon Reject BILLING PROVIDER TAXONOMY CODE IS MISSING OR INVALID. (Bad Data: XX )
  • Emdeon Reject BILLING / PAY-TO PROVIDER TAXONOMY CODE - PROVIDER TYPE QUALIFIER IS MISSING OR INVALID.

This rejection states that the provider specialty code, or taxonomy, is missing or invalid. Provider Taxonomy is set in the user reference for the provider under Provider > Claim Credentials. If the taxonomy is known, it can be manually entered into the field. The user can also select 'Choose..' and find the applicable taxonomy via a searchable menu. The claim can then be rebuilt and resent.

A taxonomy code is required for the rendering provider on all eClaims. Most payers do not want to see a taxonomy code for the billing provider on an eClaim, unless the rendering provider is billing as individual.
Note: If the provider has more than one user reference, it may be necessary to update more than one account.

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