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South Country Health Alliance rejecting H0001 0900 claim

Katie Scharberg 3 months ago in Billing/Electronic Modules • updated 3 months ago • 2

Hello, 

I am getting a rejection from SCHA for a chemical health assessment (H001 0900) for just one client stating:

Category: Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Status: Claim/submission format is invalid

Category: Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Status: HCPCS

Category: Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Status: Date(s) of service

I have verified eligibility for the date of service.

 

I opened a ticket with Procentive and they are saying that I need to send the claim as a Professional claim but we have ALWAYS billed as institutional without errors. I am SO confused and frustrated. Has any other CD billers ran into this issue with SCHA? Was there an update I missed regarding SCHA not accepting assessments as institutional claims? 

Thanks, 

Katie 

Sheila Paulus 3 months ago

I would reach out to SCHA and confirm with them. They could have changed the same way Primewest did in 2022. I've found that the form to use not only varies by payer, but it varies by provider and contract as well. 

Katie Scharberg 3 months ago

Hi Sheila, 

Thanks for your advice - I literally just got off the phone with them. They are researching further as it did send as an institutional claim and SHOULD be processing. 

Thanks :) 


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