Payer Log File Responses

The following sections contain tables detailing the most common Payer EDI Log File responses and the recommended actions to take for successfully addressing each.

The following table provides rejection Status Codes, Import Status, and the recommended resolutions for each listed rejection.

Status Code Import Status Description Nightly Reprocess Resolver How to Resolve
200 Success or Skip   No    
201 Payer ID is required Required field was not populated. No Payer Populate PayerID field
202 Admission ID is required Required field was not populated. No Payer Populate AdmissionID field
203 Service Category is required Required field was not populated. No Payer Populate Service Category field
204 Service Type is required Required field was not populated. No Payer Populate Service Type field
205 Authorization Number is required Required field was not populated. No Payer Populate Authorization Number
206 Billing Service Code is required Required field was not populated. No Payer Populate Billing Service Code
207 From Date is required Required field was not populated. No Payer Populate 'From Date'
208 To Date is required Required field was not populated. No Payer Populate 'To Date'
209 Authorization Type is required Required field was not populated. No Payer Populate Authorization Type
210 Hours Per Week is required as Authorization Type is "Weekly" Auth Type Set to Weekly but Hours Per Week was not Populated. No Payer Provide Hours in 'Hours Per Week'
211 Hours Per Month is required as Authorization Type is "Monthly" Auth Type set to Monthly but Hours Per Month was not populated No Payer Provide Hours in 'Hours Per Month'
212 Hours Per Auth Period is required as Authorization Type is "Entire Period" Auth Type set to Entire Period but Hours Per Auth Period was not populated No Payer Provide Hours in 'Hours Per Auth Period'
213 Insurance 1 is required Required field was not populated. No Payer Populate 'Insurance 1' field
214 Additional Rules is required Required field was not populated. No Payer Populate 'Additional Rules' field
215 “Is Deletion” is required Required field was not populated. No Payer Populate 'Is Deletion' field
216 Patient never received from Payer. If we NEVER RECEIVED a member from a payer, then the system rejects authorization with the rejection message: Patient never received from Payer. Yes Payer The patient record needs to be sent
216 Patient failed to import into Payer Portal. If a Member is received but they are rejected on the member file, the system rejects with the rejection message: Patient failed to import into Payer Portal. Yes HHAeXchange/ Payer Refer to the member rejection
217 Duplicate Patient found in HHAeXchange Multiple records for the patient exist. This typically occurs because one or more records were manually created in the portal. (At least one record was not created through the file import porcess) Yes HHAeXchange/ Payer Two patients with matching records were found in the portal. Work with Payer on correcting or removing the duplicate record
218 Invalid Provider ID or Provider is not linked with Payer. If Provider ID given in Authorization is not linked with Payer or it is invalid. Yes Payer If the ProviderID is invalid then it needs to be corrected, if not linked then the Provider record should be included on the Provider file or a support ticket should be sent
219 Invalid Service Type Service Type is a filter for Service Code that is set up in the Configuration Document during implementation. The field exists in the Payer Portal. No Payer Need to work with Payer and HHAeXchangeCSM to resolve.
220 Billing Service Code not found in HHAeXchange The Billing Service Code needs to match one of the configured Billing Service Codes in the Payer Portal Yes Payer Verify Code is accurate - if not valid then send a corrected code, if valid then work with HHAeXchangeon adding new Service Code to Reference Table
221 Duplicate Authorization found in HHAeXchange Two matching Authorizations exist in the system with the same Auth Idenfitiers. This occurs when a user adds the auth number from the application. The interface does not allow the addition of duplicate Authorizations. Yes Payer Work with Payer on identifying the correct record. The incorrect record may need to be deleted manually and could record a TDE ticket to complete.
222 Insurance 1 not found in HHAeXchange If Insurance does not exist in reference table. No Payer Correct Insurance 1 field or add Insurance to reference table
223 Insurance 2 not found in HHAeXchange If Insurance does not exist in reference table. No Payer Correct Insurance 2 field or add Insurance to reference table
224 Insurance 3 not found in HHAeXchange If Insurance does not exist in reference table. No Payer Correct Insurance 3 field or add Insurance to reference table
225 Insurance Duration and Shift Duration do not match for Saturday/Sunday/Monday/Tuesday/Wednesday/Thursday/Friday. This applies to Daily Auth Type and happens when the Insurance Hours sent in the file and Insurance Hours added in the patient portal do not match No Payer Confirm with Payer the correct hours and if the import or portal needs to be corrected.
226 Duplicate rule details for each additional rule This rejection comes when the authorization has additional rules and have duplicate values in it. No Payer Possible Values: "Y" OR Blank. If "Y" this authorization can be restricted further through 3 additional fields "Maximum Visits 1" "Per 1" and "Of X Hours 1"
227 Authorization with invalid Additional Rules Possible Values: "Y" OR Blank. If "Y" this authorization can be restricted further through 3 additional fields "Maximum Visits 1" "Per 1" and "Of X Hours 1" No Payer Correct the 'Additional Rules' field
228 This authorization update is attempting to adjust the Authorization Dates to a range which would not include visits already billed or confirmed by your Provider using their Authorization.  This action is not allowed. The authorization has already been utilized by the Provider updating the date field cannot override or remove existing dates already billed Yes Payer / HHAeXchange CSM Consult the Payer CSMs to confirm the setting in Admin CP to allow this
229 This authorization update is attempting to reduce Authorization hours, however, your Provider has already applied and billed or confirmed for more hours using this Authorization than you are attempting to save.  This action is not allowed. The authorization has already been utilized by the provider; updating the date field cannot override or remove existing dates already billed Yes Payer / HHAeXchange CSM Consult the Payer CSMs to confirm the setting in Admin CP to allow this
230 DX1 is required. Required field was not populated. No Payer Populate DX1 field
231 Column length exceeds the maximum allowed length.   No Payer Shorten length of impacted field
232 County Mapping not found for Billing Service Code. County Mapping is set up in the Configuration Document and is not found for the provider Billing Service Code Yes Payer Involve Payer CSM to see if County Mapping needs to be updated
233 Authorization status is not valid. This is for Humana. The status must be within COMPLETE, VOID, CLOSED No Payer Humana needs to correct.
234 Authorization type is not valid. "Daily" | "Weekly" | "Monthly" | "Entire Period". This selection affects how authorization hours are transmitted to HHAeXchange. No Payer Payer needs to send an available or correct Auth Type from the available selection: "Daily" | "Weekly" | "Monthly" | "Entire Period"
235 "To Date" must be greater than or equal to "From Date" To Date' comes before 'From Date' No Payer Correct the 'To Date' or 'From Date' so the 'To Date' is greater than or equal to 'From Date'
237 More than one Provider found in HHAeXchange with same Tax ID Overlapping Providers configured to the same Provider TIN/TaxID Yes Payer / HHAeXchange CSM Consult Payer CSM to confirm if placement logic is correct and these should reject or if this should be broadcast
238 Service category is not supported. Service Category is not matching the determined category designated during configuration process No Payer Confirm they are sending the expected Service Category, update the service category if needed
239 Authorization Service Type is not configured with selected provider(s). The service type of the authorization does not configured or synced at provider side. Yes HHAeXchange TDE needs to apply the Service Type to the selected Provider Portal. Work with HHAeXchange CSM to complete task.
240 Invalid Payer ID. PayerID provided on file is not the assigned PayerID No Payer Correct PayerID field
242 Authorization cannot be deleted because it has been already applied for Confirmed or Billed Visit. The authorization has already been utilized by the provider; updating the date field cannot override or remove existing dates already billed Yes Payer / HHAeXchange CSM Consult Payer CSM to work with Payer on resolution
243 The Provider on this authorization cannot be changed due to import configuration settings. This is designated during configuration setup in the Configuration Document Yes Payer / HHAeXchange CSM Consult Payer CSM to work with Payer on resolution
243 The Provider on this authorization cannot be changed because the authorization has been utilized The original provider attached to the authorization is utilizing the authorization   Payer / HHAeXchange CSM Consult Payer CSM to work with Payer on resolution
244 Authorization with pending placement cannot be edited or deleted. Placement needs to be accepted or rejected by provider before it can be edited or deleted. Yes Payer / HHAeXchange CSM The provider must accept or reject the placement.
245 Invalid value (From Date/ To Date). Either the From Date or To Date was populated incorrectly No Payer Correct the date field. Confirm format follows: YYYY-MM-DD
247 Invalid value of Additional Rules. The values provided in this field are not valid and do not follow the specs No Payer Possible Values: "Y" OR Blank. If "Y" this authorization can be restricted further through 3 additional fields "Maximum Visits 1" "Per 1" and "Of X Hours 1"
248 Provider is not configured with Rate Schedules for the selected Service Code. The Placement will not be sent. Rates Schedules for the selected Service Codes have not been configured for the selected provider. Yes Payer/ HHAeXchange CSM/ Provider Onboarding Consult Payer CSM and Provider Onboarding if this rejection is received
249 Multiple messages related to maximum visits from 1 to 7 Errors/Rejection due to Maximum Visits field not follow specifications. No   Required if Additional Rules = "Y". Whole number between 1 and 999
250 Maximum Visits 1 is required if Additional Rules = "Y". Additional Rules have been sent = 'Y' but Maximum Visits was sent with an incorrect value No Payer Either update Additional Rules to include 'Maximum Visits 1' or remove 'Y' and leave field blank if there are no additional rules
251 Additional Rules can have value Y only when Authorization Type is set as Weekly, Monthly, or Entire Period. Additional Rules have been sent = 'Y' but the Auth Type was sent as Daily No Payer Confirm Auth Type is correct, update if needed, then confirm if additional rules are needed and qualified for auth type
253 Authorization exists with different authorization type cannot be updated. Cannot modify “Authorization Type” for an existing authorization. No Payer Involve CSM and Payer to designate next steps. If this needs to be changed, then end current auth in system and send a new authorization with the corrected data.
254 DX3 value cannot be added without DX2. Diagnosis Codes need to be populated in order starting with DX1 No Payer Populate DX2 before populating DX3 if a second Diagnosis Code is needed
255 Patient pending placement is not accepted by provider. The placement was previously rejected by provider. No Payer Payer needs to contact provider. Involve CSM as needed.
256 Placement is pending for selected provider. This is a successful import that now needs the provider to accept the placement Yes Provider Next action is for the Provider to manage. Provider needs to either accept or reject the placement.
257 Overlapping Authorization found in HHAeXchange. Authorization cannot be placed because there is a different authorization already in the portal with the same service code for the same member with overlapping date range. Yes Payer Payer needs to adjust the dates or service code of the existing or new or both authorizations and then resend
258 Authorization should not be imported for different Office in the same provider. The auth being sent is already in the system with a different provider. Yes Payer / HHAeXchange CSM Tagged as Blending services and loop in the Payer CSM or change the authorization number of the new auth you are submitting and resend row.
259 You are attempting to reduce Authorization limits, however, visits have already been billed in excess of this new reduced limit. This action is not permitted. The authorization has already been utilized by the provider; updating this field cannot override or remove existing fields already billed No Payer Contact CSM and Payer for next steps.
260 X cannot be set to '0' (Where X=Hours Per Auth Period/Hours Per Week/Hours Per Month/Units/Daily Hours ) The corresponding Hours fields for the sent Auth Type are not populated. No Payer Payer needs to send Hours populated based on the Auth Type they ares sending.
260 Invalid value of X Hours( Where X= Sat/Sun/Mon/Tue/Wed/Thu/Fri) Auth Type is Daily and requires Sat/Sun/Mon/Tue/Wed/Thu/Fri to be populated with a number greater than or equal to 0.   Payer Payer needs to correct the Daily Hours and resend.
261 Authorization end date cannot be before Go-Live Date The Authorization End Date is prior to the Integration Go Live Date. No Payer Contact CSM and Payer for next steps.
262 Duplicate County found. This is set up in the Config Doc. A Duplicate County exists in the Reference Table. Yes Payer Contact CSM for next steps.
263 The Service Code on this authorization cannot be changed due to import configuration settings. This is due to configuration settings established in the Config Doc. Yes Payer / HHAeXchange CSM Contact the CSM for next steps and loop in Payer.
263 The Service Code on this authorization cannot be changed because the authorization has been utilized. The authorization has already been utilized by the provider; updating this field cannot override or remove existing fields already billed Yes Payer Contact Payer for next steps and loop in CSM.
264 Provider ID is required Required field was not populated. No Payer Populate Provider ID field
265 Duplicate Service Code found A duplicate Service Code exists in the reference table No Payer / HHAeXchange CSM Contact the CSM for next steps and loop in Payer.
266 Service Code Mapping Not Found The Service Code mapping does not exist in the reference table Yes Payer / HHAeXchange CSM Contact the CSM for next steps and loop in Payer.
267 [Office Identifier] is required Office Identifier is dynamic No HHAeXchange CSM Contact the HHAeXchange CSM
268 Invalid [Office Identifier] Office Identifier is dynamic Yes HHAeXchange CSM Contact the HHAeXchange CSM
269 Duplicate service code mapping found. A duplicate Service Code Mapping exists in the reference table No HHAeXchange CSM Contact the CSM for next steps and loop in Payer.
270 API Rejections AND more than 1 office found with the same Site ID. AND more than 1 office found with the same NPI. API rejections and Multiple Office Found Yes Payer / HHAeXchange CSM Contact the CSM for next steps and loop in Payer.
271 Provider does not exist in HHAeXchange ProviderID and/or TIN does not having a matching provider portal. Yes Payer Confirm that the ProviderID and TIN are correct. If correct, then contact provider.
272 Provider is not linked to Payer Provider Portal exists but is not linked to Payer. Yes Payer Include Provider record on Provider file to have provider linked.
273 Duplicate Provider found in HHAeXchange with same Site ID. There are duplicate providers with the same Site ID on the reference table Yes Payer / HHAeXchange CSM Contact the CSM for next steps and loop in Payer.
274 Internal Contract not found for Provider. Provider configuration issue. Yes HHAeXchange CSM Contact HHAeXchange CSM
275 The Patient is active with multiple Providers with the same TAXID. This is a blended services rejection and requires additional review. No HHAeXchange CSM Contact HHAeXchange CSM
276 Program Code Length exceeds 50 characters. The character limit is 50 for this field No Payer Shorten length of Program Code
277 Invalid value of Budget Amount. Max Value Allowed: 9999999.99 No Payer Correct Budget Amount: Dollar Value for the Authorization. Required if the Authorization uses a dollar value. Max Value Allowed: 9999999.99
278 Budget Amount Length Exceeds allowed length. Max Value Allowed: 9999999.99 No Payer Field character limit is 10 digits
279 Budget Amount Value Exceeds allowed limit. Max Value Allowed: 9999999.99 No Payer Max Value Allowed: 9999999.99
280 Multiple messages based on validation if Monday to Sunday hours of Daily Type Auth. like Invalid value of Sun Hours. A blank or non-numeric value is being used in this field when it is required. No Payer If Authorization Type is Daily then the Hours for Monday through Sunday need to be populated with a numeric value or zero - cannot be blank.
281 The Provider on this authorization cannot be changed because the patient does not have an active placement with the requested provider. Please send a new authorization to the requested provider. You may delete the authorization currently linked with the incorrect provider. Update/Change/Delete request for this authorization is being sent to a Provider that does not have the existing authorization Yes Payer Correct the Provider associated with the record or delete the existing record with the current provider and resend for the new provider
282 This authorization is attempting to send a new placement to more than one provider, which overlaps with the previous placement. This action is not allowed. Authorization cannot be placed because there is a different authorization already in the portal with the same service code for the same member with overlapping date range. Yes Payer Correct the date range of the existing, new or both authorizations and resend
283 Patient does not have Primary Insurance information in Profile. Primary Insurance is sent on the Patient Demographic file, in this instance, it was not provided No Payer Payer needs to update the Primary Insurance field on the Patient Dem file or manually update the profile in the portal
284 The Patient is on HOLD or Hospitalized. The Authorization has not been imported. The patient status is on Hold which prevents importing Authorizations No Payer The Patient Status needs to be updated, this can be done manually in the portal.
298 Authorization does not exist in HHAeXchange. You have sent a request to delete or update this authorization record but the record does not exist in HHAeXchange No Payer If deleting the authorization and the record doesn't exist then the delete request can be removed from the auth file. If attempting to update an authorization, the record must be sent on the auth file to be created first
299 Other(Technical rejections) Unknown Error, Contact HHAeXchange Support for more details Yes HHAeXchange Contact HHAeXchange CSM

The following table provides rejection Status Codes, Import Status, and the recommended resolutions for each listed rejection.

Status Code Import Status Description Nightly Reprocess Resolver How to Resolve
100 Success   No    
101 Payer ID is required. Required field is blank and needs to be provided No Payer Provide Required Field
102 Admission ID is required. Required field is blank and needs to be provided No Payer Provide Required Field
103 First Name is required. Required field is blank and needs to be provided No Payer Provide Required Field
104 Last Name is required. Required field is blank and needs to be provided No Payer Provide Required Field
105 Gender is required or Invalid value of Gender. Required field is blank and needs to be provided No Payer Provide Required Field
106 DOB is required. Required field is blank and needs to be provided No Payer Provide Required Field
107 Address 1 is required. Required field is blank and needs to be provided No Payer Provide Required Field
108 City is required. Required field is blank and needs to be provided No Payer Provide Required Field
109 State is required.  Required field is blank and needs to be provided No Payer Provide Required Field
110 Insurance 1 is required. Required field is blank and needs to be provided No Payer Provide Required Field
111 Zip is required. Required field is blank and needs to be provided No Payer Provide Required Field
112 Zip can not be greater than 5. 5-digit Zip Code was not provided No Payer Correct Zip and resend
112 Zip can not be greater than 9. For MOLINA,SUNSHINE and SUNSHINEFL only. No Payer Correct Zip and resend
112 Zip cannot be greater than 9. Provide either the 5-digit zip code or 9-digit zip code. No Spaces or special characters. No Payer Correct Zip and resend
112 Zip cannot be less than 5. 5-digit Zip Code was not provided No Payer Correct Zip and resend
113 Incorrect format of DOB. Required Format: YYYY-MM-DD No Payer Correct format and resend
114 Incorrect format of Projected Discharge Date. Required Format: YYYY-MM-DD No Payer Correct format and resend
115 Invalid Value of X. (where X is Column name) General code for a column that does not match the format specified in the data spec No Payer Correct value and resend
116 Incorrect format of X. (where X is Column name) General code for a column that does not match the format specified in the data spec No Payer Correct format and resend
117 Medicaid ID is required. Based on the configuration, Medicaid ID is required No Payer Provide Required Field
118 Primary Insurance is required. Required field is blank and needs to be provided No Payer Provide Required Field
119 Member ID is required. Required field is blank and needs to be provided No Payer Provide Required Field
121 Zip cannot be greater than 9. Provide either the 5 digit zip code or 9 digit zip code. No Spaces or special characters. No Payer Correct Zip and resend
125 Insurance 1 not found in HHAeXchange Provided value in Insurance 1 field is not found on the Insurance reference table No HHAeXchange CSM / Payer Coordinate with CSM and Payer to verify if Insurance value needs to be added to reference table
126 Patient cannot be discharged with future date as it is in 'Waiting' status. The patient status is Waiting. There are no services and nothing to discharge No Payer Assign services and authorization to update status or remove member
127 Insurance 2 not found in HHAeXchange Provided value in Insurance 2 field is not found on the Insurance reference table No HHAeXchange CSM / Payer Coordinate with CSM and Payer to verify if Insurance value needs to be added to reference table
128 Insurance 3 not found in HHAeXchange Provided value in Insurance 3 field is not found on the Insurance reference table No HHAeXchange CSM / Payer Coordinate with CSM and Payer to verify if Insurance value needs to be added to reference table
129 Discharge date must be greater than last Billed Date. Attempting to Discharge the member before the Last Billed Date No Payer Discharge Date needs to be after the last Billed Date. Payer must update and resend record.
130 Patient cannot be discharged as some visits are already scheduled and may be visited. Payer is attempting to discharge the member even though the member has scheduled visits No

Payer

/ Provider / HHAeXchange CSM

 Coordinate with CSM and Payer to verify what actions need to be taken. Loop in Provider if they need to remove the scheduled visits.
131 Visits are made after the discharge date. Payer is attempting to discharge the member even though the member has had visits completed that would fall after the new discharge date No Payer / Provider / HHAeXchange CSM Coordinate with CSM and Payer to verify what actions need to be taken. Loop in Provider if needed
132 Discharge date should be greater than Start of care date. Payer is sending a discharge date that is before the Start of Care Date No Payer Remove record or update the Discharge Date
133 Patient must be placed with one vendor only. Payer specific rejection No HHAeXchange CSM / Payer Coordinate with HHAeXchange CSM and Payer for next steps
138 Duplicate Patient found in HHAeXchange There are two Patient Profiles created. Often one is imported and a second is manually created by the payer. No Payer Clean, remove or merge the records so the updated record can be imported
140 Invalid Payer ID Incorrect value provided in Payer ID field. Correct Payer ID needs to be sent. No Payer The Payer ID needs to be corrected and resent.
141 Primary Insurance is required Required field is blank and needs to be provided No Payer Provide Required Field
142 Duplicate Medicaid ID with Different Admission ID Found. The Medicaid ID sent exists with a different Admission ID No Payer Confirm correct Medicaid ID and Admission ID combination. May need to remove the bad record or patient if needed.
143 Incorrect format of StartOfCare Date. Required Format: YYYY-MM-DD No Payer Correct format and resend
198 Skip Record already exists as is sent. This is not a rejection. No HHAeXchange No action required.
199 Other Unknown Error, Contact HHAeXchange Support for more details Yes HHAeXchange  
 112 Invalid Value of Zip. General code for an invalid value in the Zip Code. No Payer Depends on the config doc. Provide either the 5-digit or 9-digit zip code. No Spaces or special characters.