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            EDI Claim Error-Pmts Adj Pt Resp Does Not Balance to Zero

            Reasons that Claims Don’t Balance Error Message Occurs

            The signs in the transactions (-) may be incorrect

            Must have patient responsibility lines 

            Adjustment Codes may not be mapped in the database to a CO 45 or PR code, will need to check with Development. Look at the adjustment code, is it a code that is not commonly used. 

            The Insurance that pays from the Primary must be the same insurance that is currently in the system. You can’t just delete, you should always terminate and add new insurance plans.

            Updated: 23 Aug 2017 11:15 AM
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