Claim Rejection: Invalid Rendering Provider NPI#

Claims can be rejected due to inaccuracies in the National Provider Identifier (NPI) number of the rendering provider. The NPI serves as a unique identifier for healthcare providers. When this number is incorrect or mismatched with the provider's information, it can lead to claim rejections. Such errors can occur due to data entry mistakes or outdated provider information in the system. Resolving these rejections often involves verifying and updating the correct NPI number and ensuring its accuracy in future claims submissions. 

Rejected claims due to an invalid NPI number for the rendering provider

Begin by, navigating to the Application Dashboard and clicking on Rejected Claims in the Alerts section.

On the claims tab under rejected, click the orange triangle located in the Rejection Status column which displays the reason for the rejection.


Click the Claim# to view the claim form.

In this example, the CMS 1500 HCFA form is displaying the incorrect NPI#.

Update rendering provider NPI#

Next, navigate to Utilities, Providers, and Rendering Providers. Select the Rendering Provider and update the provider NPI#.

Resubmit claim

Under Rejected, select the Checkbox next to the encounter # and click Send Selected.

The claim will be resubmitted and placed in the Pending tab with the correct NPI#.


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