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Validation Errors

Overview

The following tables contain common errors that a user may see when validating insurance. You will notice there are multiple codes that relate to the same essential problems. That is because different payers choose different ways of describing what went wrong during the validation process.

Practice/Provider Missing Required Data/Field Errors

Validation Error Code
Meaning of Error
15Required application data missing. This may be due to the eligibility enrollment contract or possibly the payer does not support the eligibility functionality.
43

Invalid/missing Provider ID. This could mean that the NPI being used for validation is different than what the payer has on file.

50

Provider not eligible for inquiries.

51Provider not on file.
52Service dates not within Provider plan enrollment.

Time Out Errors

Validation Error Code
Meaning of Error
42Unable to respond at current time.
80Timed out - retry later.

Subscriber or Patient Detail and Eligibility Errors

Validation Error Code
Meaning of Error
21Subscriber/insured not found.
27Policy cancelled.
30Subscriber/ID mismatched.
33Subscriber/ID not found.
58Invalid/missing birth date.
60Date of birth occurs after date of service.
62Date of service outside allowable inquiry period. This usually occurs on forward dates on the schedule.
63Does not support date of service in future.
64Invalid/missing patient ID.
65Invalid/missing patient name.
67Patient not found during valid request. This means that the eligibility request was likely asked of the wrong payer.
68Duplicate patient ID.
71Patient DOB mismatch (often infants).
72Invalid/missing subscriber ID.
73Invalid/missing subscriber/insured name.
74Invalid/missing sex.
75Subscriber not found.
76Duplicate subscriber ID.
79Invalid participant information.
88Not eligible on date of service.