eClaims - Common Rejections - Patient Payment Applied to Claim

Patient Payment Applied to Claim
Rejection Message:

  • The Patient Paid Amount (AMT02) must not exceed the Claim Charge Amount (CLM02). Segment AMT is defined in the guideline at position 1750. Invalid data- XX

This rejection is stating that there is a patient payment that is tied to the one or more of the associated charges on the claim. Applying patient payment before primary and secondary have paid may very well cause either or both of the payers to pay a reduced amount than contracted or expected, even if the amount reflects a copay or deductible. It is advised that no patient payment amount be applied to any charges until all necessary claims have been sent and reported back on by the payers.

To fix the claim, unapply any patient payments tied to the affected charges and rebuild the claim.

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