Rejection Message: Out of Balance Secondary Claims

Rejection Message

Out of Balance Secondary Claims

Definition

This rejection occurs when the primary payer's adjudication does not equal the charge amounts per line item on the secondary claim. The common causes for this are:

• Adjustments repeated on the claim level and line item level
• COB information missing on one or all service lines
• COB information is incorrect

Resolution

To resolve this rejection:

1. Navigate to Patient Treatment Episode > Insurance Billing > Payments.
   
2. Locate and select the payment.
3. Verify that the payment posting is posted by line item. 
4. Once the payment has been updated, select Resubmit in Links.
   
5. Select "No Changes".
   
6. Toggle Go to Submit Claims on Create and create the claim resubmission.
   
7. Submit.