American Academy of Family Physicians

Practice & Professional Issues


Claims Edit Misfire Causes 450,000 Claims Rejections Nationwide

Clearinghouse Advises Physicians to Resubmit

(5/23/2012, 1:45 p.m.)  --  Health insurer Humana recently notified a number of physician organizations and other affected entities about a glitch in its request for implementation of a valid 5010 transaction claims edit that ultimately resulted in the rejection of some 450,000 claims. Affected health care claims were submitted between April 26 and May 10 to Humana's designated claims clearinghouse, Availity LLC. According to Humana, any physician who submits claims directly to Availity or who submits claims through a clearinghouse that forwards claims to Availity likely will experience rejected claims. More


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