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Eligibility Rejection: Invalid/Missing Provider Specialty (Procentive)


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  • Updated

Overview

This is a common rejection from eligibility, when run through DHS. When this rejection message is received, it's likely that there is an issue with the taxonomy codes for your agency on MN-ITS.
 

Rejection Message
Eligibility_Rejection_6.18.20.png

Resolution

What appears on the batch report sent to DHS for eligibility must match what is on the provider file. To determine which taxonomy code is being submitted on the eligibility request there are two options:

  1. Go to the Eligibility Module
  2. Click the response link

    Eligibility_response_link_6-19-2020.png

  3. Click on the Raw check box on the bottom left to see the raw data submitted.

    Eligibility_Raw_Taxonomy_6.18.20.png

     
  4. Go to the Electronic Module > radio button "Eligibility Inquiries" at the top > click on the link/file that was submitted.

    Electronic_Eligibility_Inquiries_6.18.20.png

    • This option is makes it much more difficult to tell which inquiry is which, so you will likely prefer Option 1.

 

Once you have determined which taxonomy code is being submitted you will then need to verify it is the same as your Provider File on MN-ITS. If you're unsure where to find this on MN-ITS, please contact DHS directly.

  1. Go to MN-ITS > Verify that your taxonomy codes are setup correctly in your Provider File.
  2. Go to Locations Module > Billing tab.

    Location_Billing_Taxonomy_6.18.20.png

    • Verify that the location taxonomy code has been setup.
      • If a provider has multiple locations setup in their Provider File on MN-ITS, they need to also have unique taxonomy codes setup for each location as well.
      • Per DHS, if a provider has been setup as "Consolidated" AND they have multiple locations, their Provider File must also be setup with the unique locations and unique taxonomy codes.
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