Top Claim Submission Errors and How to Resolve
Claim submission errors (CSEs) cause your billing transactions to either reject or move to your Return to Provider (RTP) file for correction, and create unnecessary costs to the Medicare program. Remember that it is your responsibility as a Medicare provider to ensure the information submitted on your billing transactions is correct and compliant with Medicare regulations. For detailed instructions about how to correct claims in your RTP file, refer to the Claims Corrections section of the FISS Reference Guide.
Providers should be aware that action may be taken when they demonstrate a pattern of submitting claims inappropriately, incorrectly or erroneously, including a referral to the Office of Inspector General (OIG) for Medicare fraud or abuse.
Below is a list of the top errors listed by provider type. Please click on the link to access the specific reason code, as well as resources you can use to avoid future billing errors.
Home Health/Hospice Providers
Home Health Providers
Hospice Providers
Page last updated: October 21, 2009
