Category Status Code Entity Code Category Description Status Description
A0
570
Accepted
A1
16
Accepted
A1
19
Accepted
A1
19
Accepted
A1
20
PR
Acknowledgement/F orwarded-The claim/encounter has been forwarded to another entity. Acknowledgement/R eceipt-The claim/encounter has been received. This does not mean that the claim has been Acknowledgement/R eceipt-The claim/encounter has been received. This does not mean that the claim has been Acknowledgement/R eceipt-The claim/encounter has been received. This does not mean that the claim has been Acknowledgement/R eceipt-The claim/encounter has been received. This does not mean that
Claim/encounter has been forwarded to entity. Note: This code requires use of an Entity Code. Entity acknowledges receipt of claim/encounter. Note: This code requires use of an Entity Code. Payer Entity acknowledges receipt of claim/encounter. Note: This code requires use of an Entity Code.
Description Acknowledgement of receipt of claim by insurance company. This does not mean the claim has been accepted for processing. Acknowledgement of receipt of claim by insurance company. This does not mean the claim has been accepted for processing. Acknowledgedment of receipt of claim by insurance company. This does not mean the claim has been accepted for processing. Acknowledgedment of receipt of claim by insurance company. This does not mean the claim has been accepted for processing.
Accepted for processing.
The insurance company has received and accepted the claim for processing. No action required.
Entity Description
Free Form Message Text
Action
This claim NEEDS ATTENTION. This will vary, depending on the text.
No action required.
No action required.
No action required.
Accepted
Accepted
Accepted
Accepted
Rejected
A1
A2
A2
A2
A3
570
Acknowledgement/R eceipt-The claim/encounter has been received. This does not mean that the claim has been accepted for adjudication. Acknowledgement/A cceptance into adjudication systemThe claim/encounter has been accepted into the adjudication Acknowledgement/A cceptance into adjudication systemThe claim/encounter has been accepted Acknowledgement/A cceptance into adjudication systemThe claim/encounter has been accepted
33
Acknowledgement/R eturned as unprocessable claimThe claim/encounter has been rejected and has not been Subscriber and entered into the subscriber id not adjudication system. found.
26
19
20
85
PR
Entity not found. Note: This code requires use of an Entity Code. Entity acknowledges receipt of claim/encounter. Note: This code requires use of an Entity Code.
Billing Provider
Acknowledgement of receipt of claim by insurance company. This does not mean the claim has been accepted for processing. Provider may receive a request for more information. If you do not receive correspondance, you may want to resubmit No action required.
Payer
The insurance company has received and accepted the claim for processing. No action required.
Accepted for processing.
The insurance company has received and accepted the claim for processing. No action required.
Free Form Message Text
The insurance company has received and accepted the claim for processing.
This claim NEEDS ATTENTION. This will vary, depending on the text. This claim NEEDS ATTENTION. Please see the Knowledge Base articles for Insurance Claims The claim has been Needing Attention rejected for processing, and Correcting due to incorrect policy Insurance Policy information. Information.
Rejected
Rejected
Rejected
A3
A3
A3
570
Acknowledgement/R eturned as unprocessable claimThe claim/encounter has been rejected Free Form Message and has not been Text
30
Acknowledgement/R eturned as unprocessable claimThe claim/encounter has been rejected and has not been Subscriber and entered into the subscriber id adjudication system. mismatched.
27
Acknowledgement/R eturned as unprocessable claimThe claim/encounter has been rejected and has not been entered into the adjudication system. Policy canceled.
IL
Insured
This claim NEEDS ATTENTION. This will vary, depending on Rejected for processing the text. This claim NEEDS ATTENTION. Please see the Knowledge Base articles for Insurance Claims The claim has been Needing Attention rejected for processing, and Correcting due to incorrect policy Insurance Policy information. Information. No action required. This claim will move forward to be billed to the next payer (Medicaid or Escrow). However, if insurance policy has expired, provider may want to The claim has been see Knowledge Base rejected. The patient is article on Correcting no longer covered by Insurance Policy this insurance policy. Information.
Rejected
Rejected
Rejected
Rejected
A3
A3
A6
A6
88
88
QC
3
743
137
82
Acknowledgement/R eturned as unprocessable claimThe claim/encounter has been rejected and has not been entered into the adjudication system.
Acknowledgement/R eturned as unprocessable claimThe claim/encounter has been rejected and has not been entered into the adjudication system. Acknowledgement/R ejected for Missing Information - The claim/encounter is missing the information specified Acknowledgement/R ejected for Missing Information - The claim/encounter is missing the information specified
Entity not eligible for benefits for submitted dates of service. Note: This code requires use of an Entity Code. Dependent
No action required. This claim will move forward to be billed to the next payer (Medicaid or Escrow). However, if insurance The claim has been policy has expired, rejected for processing, provider may want to as the patient was not see Knowledge Base covered by insurance article on Correcting policy on date of Insurance Policy service. Information. No action required. This claim will move forward to be billed to the next payer (Medicaid or Escrow). However, if insurance The claim has been policy has expired, rejected for processing, provider may want to as the patient was not see Knowledge Base covered by insurance article on Correcting policy on date of Insurance Policy service. Information.
Entity’s credential/enrollment information. Note: This code requires use of an Entity Code.
No action required. This claim will move The claim has been forward to be billed to rejected due to missing the next payer information. (Medicaid or Escrow).
Entity not eligible for benefits for submitted dates of service. Note: This code requires use of an Entity Code. Patient
No action required. Entity's plan network The claim has been This claim will move id. Note: This code rejected for processing forward to be billed to requires use of an due to an out of the next payer Entity Code. (Medicaid or Escrow). Rendering Provider network provider.
Rejected
A6
249
Rejected
A6
505
82
Rejected
A7
153
PR
Rejected
A7
26
85
Rejected
A7
500
QC
Acknowledgement/R ejected for Missing Information - The claim/encounter is missing the information specified Acknowledgement/R ejected for Missing Information - The claim/encounter is missing the information specified Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected.
Place of service.
No action required. The claim has been This claim will move rejected for processing forward to be billed to due to missing the next payer information. (Medicaid or Escrow).
The claim has been rejected for processing due to a missing first name for the rendering This claim NEEDS ATTENTION. Rendering Provider provider. The IFA needs to update the payer ID for this insurance The claim has been company. Please Entity's id number. rejected for processing contact provider Note: This code due to the payer ID support at requires use of an used to electronically ProviderSupport@EIBi Entity Code. bill the claim. lling.com. Payer The IFA needs to correct this issue. Please contact provider support at ProviderSupport@EIBi Entity not found. The claim has been lling.com if you see Note: This code rejected for processing this rejection and see requires use of an due to invalid billing that the claim has not Entity Code. provider information. been rebilled. Billing Provider This claim NEEDS ATTENTION. The child's address information needs to Entity's Postal/Zip The claim has been be updated in NYEIS Code. Note: This code rejected for processing or KIDS. Please requires use of an due to invalid patient contact the county for Entity Code. zip code. further assistance. Patient Entity's First Name. Note: This code requires use of an Entity Code.
Rejected
Rejected
Rejected
Rejected
A7
A7
A7
A7
54
Acknowledgement/R ejected for Invalid Information - The claim/encounter has Duplicate of a invalid information as previously processed specified in the Status claim/line.
The claim has been rejected for processing as a duplicate claim.
26
Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected.
Patient
The claim has been rejected due to incorrect policy information.
Insured
The claim has been rejected for processing due to an invalid policy ID.
153
255
QC
IL
Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status
Entity not found. Note: This code requires use of an Entity Code.
Entity's id number. Note: This code requires use of an Entity Code.
Diagnosis code.
The claim has been rejected for processing due to an invalid ICD-9 code.
No action required. This claim will move forward to be billed to the next payer (Medicaid or Escrow). This claim NEEDS ATTENTION. Please see the Knowledge Base articles for Insurance Claims Needing Attention and Correcting Insurance Policy Information. This claim NEEDS ATTENTION. Please see the Knowledge Base articles for Insurance Claims Needing Attention and Correcting Insurance Policy Information. This claim NEEDS ATTENTION. Please see the Knowledge Base articles for Insurance Claims Needing Attention.
Rejected
Accepted
Accepted
Rejected
A7
F0
F1
P0
503
570
570
0
85
Acknowledgement/R ejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected. Finalized-The claim/encounter has completed the adjudication cycle
Finalized/PaymentThe claim/line has been paid. Pending: Adjudication/DetailsThis is a generic message about a pended claim. A pended claim is one for which no
Free Form Message Text
This claim NEEDS ATTENTION. Please see the Knowledge Base articles for Insurance Claims The claim has been Needing Attention rejected for processing, and Correcting due to incorrect policy Insurance Policy information. Information. The insurance company This claim NEEDS has received and ATTENTION. This will accepted the claim for vary, depending on processing. the text. Provider should enter received EOB into Reporting EOB's screen on EIBilling.com. Please see Knowledge Base The claim has been article on Entering accepted and paid. EOB's.
Cannot provide further status electronically.
This claim is pending. The insurance company This claim NEEDS has not provided more ATTENTION. This will information. vary.
Entity's Street Address. Note: This code requires use of an Entity Code.
