Common Compliance Errors Detected by the IHCP Translator
Transactions can be rejected for compliance errors in the ISA
envelope. The ISA must be received exactly as expected.
The IHCP
Companion Guides contain the valid ISA envelope values.
Common rejections due to invalid data in ISA
Duplicate file received
- ISA06 and GS02 contain test ID, when data sent is production
data
- ISA06 and GS02 contain login ID instead of trading partner
ID
- ISA08 and GS03 do not contain IHCP
- ISA15 contains T instead of P for Production
- Trading partner ID received in ISA06 does not match the trading
partner ID linked to the login ID used to send file
- File is not X12 - sending proprietary format or non-IHCP
data
Files rejected due to these reasons will not create a 997 or
Biller Summary Report and will not be processed.
Common rejections due to missing or invalid data with the
transaction:
- 837 Billing of
Crossover Claims Directly contains instructions for the billing
of claims to the IHCP for dually eligible members (Medicare and
Medicaid) that are initiated by the provider.
- 837 Billing of TPL Claims
contains instructions for the billing of claims to the IHCP with
Third Party Liability (TPL) coverage.
- CLM02 does not equal the total of SV02 segment - results from
the total claim charge does not equal the total of all the
details.