> ## Documentation Index > Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt > Use this file to discover all available pages before exploring further. # ClaimMD-Specific Clearinghouse Rejection Reference > Reference guide for rejection messages generated by the ClaimMD clearinghouse and how to resolve them in Elation Billing When a claim is rejected by ClaimMD before it reaches the payer, you will see a message in the Claim History panel on the superbill formatted as: ```text theme={null} [Date] @ [Time] - REJECTION by CLAIM.MD • [Rejection message] ``` These rejections mean the claim never reached the payer for adjudication. You must correct the issue in Elation Billing and resubmit from the Claims Queue. This article covers the most common ClaimMD-generated rejection messages and how to resolve them. For payer-generated denials (CO/PR codes from ERAs), see [Common Claim Rejections and Denials](/articles/common-code-denials). *** ## Category 1 — EDI Formatting & Field Validation | ClaimMD Rejection Message | What It Means | Common Cause | Fix | | ---------------------------------------------------------------------------------- | -------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------ | -------------------------------------------------------------------------------------------------------------- | | `Invalid Facility City []` | City field is blank in the claim's service location | City disappears when a new location is saved in Elation Billing | Go to **Settings → Locations** → edit the affected location and re-enter the city → save → re-submit the claim | | `Tax ID must be 9 digits` | EIN in the claim is missing or malformed | EIN not populated in Practice Settings (HCFA Box 25) | Confirm 9-digit EIN in **Settings → Practice Info** | | `Diagnoses [XXXXX] is valid, but not for this date [MM/DD/YYYY]` | ICD-10 code was valid at some point but is not billable for that date of service | Practice using a retired, deleted, or parent-level ICD-10 that requires a more specific child code (typically after Oct 1 annual or Apr 1 CMS updates) | Update to the correct billable code for that DOS; Elation's ICD-10 code database updates with CMS annually | | `Code 562 — Billing Provider NPI and Taxonomy NOT VALID against State Master File` | NPI + Taxonomy combination fails state-level validation | Provider credentialing not reflected in the state (e.g., Texas) master file | Verify NPI/Taxonomy in NPPES; may need re-credentialing or correction at the state MAC | *** ## Category 2 — Submitter / Payer ID Errors | ClaimMD Rejection Message | What It Means | Common Cause | Fix | | ------------------------------------------------ | ------------------------------------------------------------------------- | -------------------------------------------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------------------------- | | `Valid [PAYER NAME] submitter ID is required []` | ClaimMD does not have a recognized submitter ID configured for that payer | Missing or incorrect Submitter ID in payer configuration; common with BCBS plans | Confirm the correct Submitter ID in **Settings → Insurance** for that carrier; contact Elation Support to verify what ClaimMD has on file | | `Invalid or Unsupported PayerID [XXXXX]` | The payer ID entered is not recognized by ClaimMD | Wrong or outdated payer ID; payer recently changed their ID | Check the [ClaimMD Payer List](https://www.claim.md/payer-list) and update the payer ID in **Settings → Insurance** | | `Invalid or Unsupported OTHER PayerID [ISA04]` | Secondary payer ID is invalid in the secondary claim loop | Secondary payer not configured or using an incorrect ID | Update the secondary payer ID in Elation and verify against the ClaimMD payer list | *** **What is a CAS (Claim Adjustment Segment)?** The CAS is the EDI field on a secondary claim that records how the primary payer adjusted the billed amount — including contractual write-offs and patient responsibility such as deductible, coinsurance, and copay. Secondary claims must include accurate CAS data before ClaimMD will accept them. ## Category 3 — Secondary / Coordination of Benefits (COB) Errors | ClaimMD Rejection Message | What It Means | Common Cause | Fix | | ------------------------------------------------------------------------------------ | ------------------------------------------------------------------------------------ | --------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | `Medicare Type Code required when Medicare is secondary` | Secondary Medicare claim is missing the Medicare Type Code field | CAS segment not populated when Medicare is billed second, after a primary payer has paid | Enter the Medicare Type Code in the secondary claim before resubmitting (e.g., non-ESRD, TEFRA) | | `Atleast one adjustment code required. (primary_paid_amount_1, charge_1)` | Secondary claim is missing the adjustment reason code(s) from the primary ERA | Manual secondary posting submitted without entering primary payment reason codes | Post the primary ERA first, or manually enter adjustment codes (CAS segment) before submitting to the secondary payer | | `Adjustment Amounts total [X] but must total the amount "Not Paid" [Y], over by $-Z` | The CAS adjustment amounts on the secondary claim don't add up to the unpaid balance | Incorrect amounts entered when posting primary payment manually, or a corrected claim has stale adjustment data | Review each Payment via Claim History → Financial Transactions: (1) Only the Primary Payment should include Allowed/Adjustment amounts — adding these to subsequent Payments causes over-adjustment. (2) Every Adjustment amount must include an Adjustment Code, or the claim becomes unbillable. (3) Apply remaining balances to Deductible/Coinsurance/Copay per the ERA/EOB. (4) Avoid posting Denials on Payments; if needed, include only \$0 in the Payment field and omit the Allowed amount and Denial Adjustment/Code. | *** ## Category 4 — Workers Comp / Specialty Claims | ClaimMD Rejection Message | What It Means | Common Cause | Fix | | ------------------------------------------------------------------------------------------- | ----------------------------------------------------------------------------- | -------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------- | | `Workers comp/auto claim may require attachment. Re-submit claim to bypass this rejection.` | ClaimMD flags workers comp/auto claims as potentially requiring an attachment | Claim is coded with a workers comp or auto-related diagnosis or payer type | Re-submit the claim — ClaimMD's message explicitly states that resubmitting bypasses this rejection if no attachment is actually needed | *** ## Quick Reference — Most Common Rejections | Rank | Rejection | Volume | | ---- | -------------------------------------------------------- | ---------------------------------------- | | 1 | `Invalid Facility City []` | High — recurring after location saves | | 2 | `Diagnoses [XXXXX] is valid but not for this date` | High — triggers on annual ICD-10 updates | | 3 | `Medicare Type Code required when Medicare is secondary` | Medium — recurring across practices | | 4 | `Valid [Payer] submitter ID is required` | Medium — common with BCBS plans | | 5 | Secondary COB adjustment errors | Medium — D-SNP / dual-eligible patients | *** ## Related Articles * [Common Claim Rejections and Denials](/articles/common-code-denials) * [Claims Queue](/articles/claims-queue) * [Filing a Corrected Claim](/articles/filing-a-corrected-claim) * [Managing Denials in Elation Billing](/articles/managing-denials) * [Enrolling Payers for Claims, ERA, and Eligibility](/articles/enrolling-for-claims-submission-era-and-real-time-eligibility-edi) * [Claim History](/articles/claim-history)