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Determine Which Client is Rejected on a Claim (Procentive)


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Overview

Claims submitted through the ClaimLynx clearinghouse will return information based on the Procentive claim number instead of the client's name. This article will help you determine which client is associated to the Procentive claim number when a rejection has occurred.
 

Locate the Claim Number

  1. Go to the Electronic Module.
  2. Click the Batch link.
  3. Scroll to the section that shows an error or rejection - try using Ctrl+F to search on the batch report for "reject".
  4. Select and copy the Procentive claim number (begins with PR) which will appear:
    • In the Reference section.
      Claimlynx_Reference_Number.png
       
    • In the Patient Account Number section.
      Availity_Batch_Report.png
       
    • In the Transaction section under the Patient name.
      PnT_Batch_Report.png
       
  5. Click the X12 Detail or X12 Summary button.
    • X12 Detail provides the most data and is recommended however, X12 Summary can be easier for some to read.
      X12_Summary_or_Detail_button.png
       
  6. Do a search on the page using Ctrl (Command on Mac) + F and then paste the claim number into this search field.
    • This will find the same claim number on the page in the 2300 loop, CLM segment, and allow you to then determine which client this rejection belongs to.
  7. Make any necessary changes to resolve the error and resend the claim.   

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