How to Read the Exception Report.

The following items on the Exception Report are informational only. The user does not need to do anything to process the ERA File.

1. Account # Change – The account # in the database for that customer does not match the one in the ERA file.

2. Interest – The respective line item had interest accrual.

3. Invoice Not Found – The invoice in the ERA file was not found in the database.

4. Date Of Service Change – The date of service in the database for line item does not match the one in the ERA file.

5. Next Payor Set To Crossover – The ERA file has indicated that the claim information has been forwarded to the next payor.

6. HCPCS or Modifier Change – The HCPCS or modifiers in the database for that line item does not match the ones in the ERA file.

7. HCPCS Change – The HCPCS in the database for that line item does not match the one in the ERA file.

8. Modifier Change – The modifiers in the database for that line item does not match the ones in the ERA file.

9. Line Item Not Found – The line item in the ERA file was not found in the database.

10. Payment Mismatch – The payment for a line item in the ERA file is different than the value in the database.

11. Zero Payment – There was no payment for the respective line item.

12. Recoupment – There was a payment recoupment for the respective line item.

13. Miscellaneous – Unknown error.

The following items on the Exception Report should be fixed to allow the user process the ERA File.

1. Invalid Responsible ID – The responsible code was not found. Add the respective responsible code from the report then process the file again.

2. Invalid Adjustment – The adjustment code was not found. Add the respective adjustment code from the report then process the file again.