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Provider Notices

Initial Claim Rejections Effective January 1, 2021

11/19/2020 3:11:03 PM

Effective January 1, 2021 PacificSource will be implementing additional industry standard rejections that will occur at our front door once they pass through the Clearinghouse. This is an effort to help improve and ensure timely and accurate claims processing.

  • Missing/Improper/Invalid Diagnosis Codes

  • Missing/Improper/Invalid CPT/HCPCS


As a reminder, the following rejections are currently in place:

  • Missing, improper or invalid NDC

  • Required billing information invalid or incomplete

  • Rendering and/or billing provider data missing

  • Subscriber information incomplete or not found