It’s hard to tell from this description everything that needs to be fixed to eliminate the errors in the validation log.
To complicate things, the claim validator can get some things wrong, for example, when it says ‘insured last name’ is missing when it plainly is not.
Getting a valid x-12 claim file requires everything being present and correct in several places, and the errors mention more than one of them.
However-- if you’ve made a bunch of changes to the patient’s record and re-run the claim several times, the first thing to do is to get into the billing manager, select the claim and click ‘re-open’ (oval in pic below).
Then click ‘Clear Log’ (rectangle) to empty the claim error log of the errors that were detected for the original state of the claim.
But-- here are the main things that need to be correct to make a valid claim file.
- The patient record- Demographics and the insurance info appears to be complete from the screenshot
- In the fee sheet of the encounter that the claim file is for, it requires:
- All CPT codes must be justified by an ICD10 code
- Be sure the price, the units, the rendering provider, is present
- The insurance company listing (main menu: Administration/ Practice/ Insurance Companies) looks complete, but is there an x-12 partner (clearinghouse) associated with that medicare payer? I do know that medicare payers are a special case for submitting claims to but sorry to say I do not know what is different about them.
Unless you’re submitting directly to the payer it should have a ‘default x-12 partner’ specified.
- Administration/ Practice/ X12 Partners - If sending the claim to a clearinghouse it will give you the information needed to fill in the ISA and GS, etc fields here.
I hope the remedy for your problem is as simple as clearing the log and the claim, and re-running claim. If not, please feel free to come back with more questions and I’m sure somebody else can offer suggestions.
The picture referred to above: