Appointment Errors Report File Specification

OVERVIEW

CareBridge can send a daily file which will report on appointments and visits that are not currently passing data validations and have pre-billing validation errors associated with them. Any appointment or visit that has a pre-billing error associated with it will not be able to be billed or correctly transmitted to Payers and/or State Aggregators. While these pre-billing errors are also reflected in the response files associated with each visits file that CareBridge receives, this report can be helpful in seeing the pre-billing errors across all visits files sent to date.
When an appointment or visit no longer has any pre-billing errors associated with it, the appointment will no longer be reported on.
The Appointment Errors Report file will not contain the entirety of data that was sent on a visits file, but rather a subset of key attributes needed to identify a visit as well as the accompanying error.
The Appointment Errors Report file can be accessed from the Third-Party EVV vendors established CareBridge SFTP mailbox in the output folder.
The Appointment Errors Report will be generated by State and TaxID, with all outstanding appointment errors for the provider included in the file.
Vendors interested in receiving this report should email evvintegration@carebridgehealth.com to opt-in.
- For Vendors in North Carolina, this report will be enabled by default.
A PDF of this document is available here.

FILE FORMAT SPECIFICATIONS

File type: CSV (pipe-delimited)
One row per Pre-Billing Validation / Error

NAMING CONVENTION

The general naming convention is as follows:
APPOINTMENT_ERRORS_{state_prefix}_{tax_id}_{file_id}_YYYYMMDDHHMMSS.CSV

Data File Format

Field No	Field Name	Description	Data Type	Example
1	VendorName	Name of EVV vendor sending data	Alphanumeric	EVV Vendor
2	FileName	Name of the visits file that the appointment / visit was most recently sent on	Alphanumeric	VISITS_{State}_ProviderTaxID_YYYYMMDDHHMMSS.CSV
3	TransactionId	As received in the visits file	Alphanumeric	9243
4	ApptID	As received in the visits file	Alphanumeric	1231248391
5	CareBridgeApptID	CareBridge’s ID for the appointment	Numeric	1231248391
6	MemberMedicaidID	As received in the visits file	Alphanumeric	362714245
7	ProviderTaxID	As received in the visits file	Alphanumeric	208076837
8	MCOID	As received in the visits file	Alphanumeric	IA_AGP
9	ErrorCode	The error code indicating the type of issue	Alphanumeric	VCR2001
10	ErrorDescription	The description of the error code, this is dynamic based on the error	Alphanumeric	Member is not eligible for visit duration
11	ErrorSeverity	Indicates the severity of the error. This will always return ERROR	Alphanumeric	ERROR
12	AggVendor	This field identifies the Aggregation Vendor that generated the error (see AggVendors table below)	Alphanumeric	HHAeXchange

AggVendors

For visits sent to CareBridge that are then transmitted to another entity for aggregation purposes, CareBridge will pass back any errors received on these visits from the outbound aggregation vendor. Vendors will need to contact the outbound aggregation vendor for additional details regarding specific error codes. Listed below are the Vendor Names as they will appear in the AggVendor column. Errors with an AggVendor value populated and not Pre-Billing Errors.

State	Vendor Name	Payers
AR	AuthentiCare	Fee for Service
AR	HHAeXchange - Agg	Arkansas Total Care, Empower
NJ	HHAeXchange	All Payers
NJ	Horizon Agg	Horizon

Pre-Billing Validations

The following is a full list of pre-billing validations performed in the CareBridge Platform that would prevent a claim from being generated in the CareBridge Platform and would be returned as an error in the response file to the vendor that submitted the visit to CareBridge.

Error Number	entity_type	description
M1000	member	Generic Error
M1001	member	Medicaid Id
M1002	member	First name is missing or invalid
M1003	member	Middle Name
M1004	member	Last name
M1005	member	Address 1
M1006	member	City
M1007	member	State
M1008	member	Zip
M1009	member	Date of birth
M1012	member	Eligibility start date
M1013	member	Eligibility end date
M2001	member	Member not associated to an auth
P1000	provider	Generic Error
P1001	provider	Tax id
P1002	provider	Unique identifier
P1003	provider	Name
P1004	provider	Address 1
P1005	provider	City
P1006	provider	State
P1007	provider	Zip
P1010	provider	Submitter Id
P1012	provider	Must have either npi or alt_npi
A1000	authorization	Generic Error
A1001	authorization	Auth ref no
A1002	authorization	Hcpc
A1003	authorization	Diagnosis code
A1004	authorization	Provider unique id
A1005	authorization	Member unique id
A1006	authorization	Start date
A1007	authorization	End date
A1008	authorization	Units
A1009	authorization	Partition type
A1010	authorization	Modifier 1
A1011	authorization	Modifier 2
A1012	authorization	Modifier 3
A1013	authorization	Modifier 4
A2001	authorization	Provider match
A2002	authorization	Member match
A2005	authorization	Member in-eligible
A2006	authorization	Provider in-eligible
A2007	authorization	Cannot change members
A2011	authorization	No rate found for the procedure code
A2012	authorization	No unit definitions found for the procedure code
A2017	authorization	Invalid npi
VCR1001	appointment	Caregiver First Name
VCR1002	appointment	Caregiver Last Name
VCR1003	appointment	Caregiver License Number
VCR1004	appointment	Vendor name is not valid
VCR1005	appointment	Transaction Id is not valid
VCR1006	appointment	Transaction Date Time is not valid
VCR1007	appointment	Provider Id is not valid
VCR1008	appointment	Provider Name is not valid
VCR1009	appointment	Provider Tax Id is not valid
VCR1010	appointment	Provider NPI is not valid
VCR1011	appointment	Member First Name is not valid
VCR1012	appointment	Member Last Name is not valid
VCR1013	appointment	Member Medicaid Id is not valid
VCR1014	appointment	Appointment Start DateTime is not valid
VCR1015	appointment	Appointment End DateTime is not valid
VCR1016	appointment	EVV CheckIn DateTime is not valid
VCR1017	appointment	EVV CheckIn Method is not valid
VCR1018	appointment	EVV CheckIn Street Address is not valid
VCR1019	appointment	EVV CheckIn City is not valid
VCR1020	appointment	EVV CheckIn State is not valid
VCR1021	appointment	EVV CheckIn Zip is not valid
VCR1022	appointment	EVV CheckIn Latitude Longitude is not valid
VCR1023	appointment	EVV CheckOut DateTime is not valid
VCR1024	appointment	EVV CheckOut Method is not valid
VCR1025	appointment	EVV CheckOut Street Address is not valid
VCR1026	appointment	EVV CheckOut City is not valid
VCR1027	appointment	EVV CheckOut State is not valid
VCR1028	appointment	EVV CheckOut Zip is not valid
VCR1029	appointment	EVV CheckOut Latitude Longitude is not valid
VCR1030	appointment	Manual CheckIn DateTime is not valid
VCR1031	appointment	Manual CheckIn Method is not valid
VCR1032	appointment	Manual CheckIn Street Address is not valid
VCR1033	appointment	Manual CheckIn City is not valid
VCR1034	appointment	Manual CheckIn State is not valid
VCR1035	appointment	Manual CheckIn Zip is not valid
VCR1036	appointment	Manual CheckOut DateTime is not valid
VCR1037	appointment	Manual CheckOut Method is not valid
VCR1038	appointment	Manual CheckOut Street Address is not valid
VCR1039	appointment	Manual CheckOut City is not valid
VCR1040	appointment	Manual CheckOut State is not valid
VCR1041	appointment	Manual CheckOut Zip is not valid
VCR1042	appointment	Auth Reference Number is not valid
VCR1043	appointment	Service Code is not valid
VCR1044	appointment	Time Zone is not valid
VCR1045	appointment	CheckIn IVR Phone Number is not valid
VCR1046	appointment	CheckOut IVR Phone Number is not valid
VCR1047	appointment	Diagnosis Code is not valid
VCR1048	appointment	Attestation is not valid
VCR1049	appointment	Rate is not valid
VCR1050	appointment	Invalid Manual Reason is not valid
VCR1051	appointment	Invalid Late Reason is not valid
VCR1052	appointment	Invalid Late Action is not valid
VCR1053	appointment	Invalid Missed Reason is not valid
VCR1054	appointment	Invalid Missed Action is not valid
VCR1055	appointment	Invalid Claim Action is not valid
VCR1056	appointment	MCO Id is not valid
VCR1058	appointment	Employee Id is not valid
VCR1059	appointment	Early visit reason is not valid
VCR1060	appointment	Early visit action is not valid
VCR1061	appointment	EVV CheckIn distance
VCR1062	appointment	EVV CheckOut distance
VCR1063	appointment	EVV CheckIn reason is not valid
VCR1064	appointment	EVV CheckOut reason is not valid
VCR1065	appointment	Survey questions and responses are required
VCR1066	appointment	Appointment does not contain the same number of survey questions and answers
VCR1067	appointment	Caregiver tasks are required
VCR1068	appointment	Caregiver hire date is not valid
VCR1069	appointment	Caregiver type is not valid
VCR1070	appointment	Caregiver gender is not valid
VCR1071	appointment	Caregiver date of birth is not valid
VCR1072	appointment	Claim 1 invoice number is not valid
VCR1073	appointment	Claim 2 invoice number is not valid
VCR1074	appointment	Line 1 invoice number is not valid
VCR1075	appointment	Line 2 invoice number is not valid
VCR1076	appointment	Caregiver Medicaid Id is not valid
VCR1077	appointment	Appointment Id is not valid
VCR1078	appointment	Provider Medicaid Id is not valid
VCR1079	appointment	Member date of birth is invalid
VCR1080	appointment	Payer claim number 1 is not valid
VCR1081	appointment	Billing status 1 is not valid
VCR1082	appointment	Billed amount 1 is not valid
VCR1083	appointment	Billed units 1 is not valid
VCR1084	appointment	Paid amount 1 is not valid
VCR1085	appointment	Paid units 1 is not valid
VCR1086	appointment	Payer claim number 2 is not valid
VCR1087	appointment	Billing status 2 is not valid
VCR1088	appointment	Billed amount 2 is not valid
VCR1089	appointment	Billed units 2 is not valid
VCR1090	appointment	Paid amount 2 is not valid
VCR1091	appointment	Paid units 2 is not valid
VCR1092	appointment	Invalid claim action
VCR1093	appointment	Invalid member medicaid id
VCR1094	appointment	Completed visit requires member attestation
VCR1095	appointment	Appointment start after end
VCR1096	appointment	Appointment EVV checkin after checkout
VCR1097	appointment	Appointment manual checkin after checkout
VCR2001	appointment	Member is not eligible for visit duration
VCR2002	appointment	Provider is not active during visit duration based on provider active_start & active_end date
VCR2003	appointment	"Billed units exceeds max units for Authorization. Used(#{used}) & Available(#{available}) Max(#{max})"
VCR2004	appointment	"Billed units exceeds max units for Authorization per period(#{part}). Used(#{used}) & Available(#{available}) Total(#{max})"
VCR2005	appointment	"Billed units for HCPC-Mod (#{hcpc}-#{mod1}-#{mod2}) exceeds daily max. Used(#{used_units}) Allowed(#{max_units})"
VCR2006	appointment	Late visit missing late visit reason
VCR2007	appointment	Missed visit missing missed visit reason
VCR2008	appointment	Manual confirmation visit missing Manual confirmation reason
VCR2009	appointment	"Billed units (#{billed}) exceed actual units(#{actual}) based on visit CheckIn and CheckOut"
VCR2010	appointment	"Visit CheckIn(#{appt_start_at}) and CheckOut(#{appt_end_at}) are outside of authorized period(#{auth_start}, #{auth_end})"
VCR2011	appointment	Member does not match authorization
VCR2012	appointment	Visit is not associated to an authorization
VCR2013	appointment	Member is not associated to the visit
VCR2014	appointment	Reject if authorization has block claiming flag set
VCR2015	appointment	Reject if provider has block claiming flag set
VCR2016	appointment	Reject if member has block claiming flag set
VCR2017	appointment	No rate found for the procedure code
VCR2018	appointment	No unit definitions found for the procedure code
VCR2019	appointment	Invalid action given the state of in flight claims
VCR2020	appointment	Visit cannot span more than two days
VCR2021	appointment	Authorization has been termed
VCR2022	appointment	Provider does not match authorization
VCR2023	appointment	Provider is not associated to the visit
VCR2024	appointment	Appointment must contain CheckIn and CheckOut data in order to be claimed
VCR2025	appointment	Appointment overlaps with another appointment
VCR2026	appointment	Early visit is missing early visit reason
VCR2027	appointment	Late visit is missing late visit action
VCR2028	appointment	Missed visit is missing missed visit action
VCR2029	appointment	Early visit is missing early visit action
VCR2030	appointment	EVV CheckIn is outside of the allowed radius require a reason code
VCR2031	appointment	EVV CheckOut is outside of the allowed radius require a reason code
VCR2032	appointment	Vendor is not approved to send claim ICNs
VCR2033	appointment	Vendor is not approved to send line level ICNs
VCR2034	appointment	Cannot submit both claim level and line level ICNs
VCR2035	appointment	Appointment crosses midnight but only 1 ICN was provided
VCR2036	appointment	Appointment does not cross midnight but multiple ICNs were provided
VCR2037	appointment	Appointment is attempting to rollup with other appointments that contain different ICNs
VCR2038	appointment	Vendor is configured to send ICNs but did not send any
VCR2039	appointment	Claim was not submitted within the timely filing window
VCR2040	appointment	Past appointment can no longer be manually modified
VCR2041	appointment	Must have a provider npi or provider medicaid id
VCR2042	appointment	Payer does not support claim generation
VCR2043	appointment	ICNs cannot be re-used for multiple claims
VCR2044	appointment	Caregiver is not active
VCR2045	appointment	Invalid npi
VCR2046	appointment	Visit cannot exceed 24 hours
VCR2047	appointment	Visit duration cannot be zero
VCR2048	appointment	EVV CheckIn cannot be in the future
VCR2049	appointment	EVV CheckOut cannot be in the future
VCR2050	appointment	Manual CheckIn cannot be in the future
VCR2051	appointment	Manual CheckOut cannot be in the future
VCR2052	appointment	Cannot claim a visit in the future
VCR2053	appointment	Visit has an EVV CheckOut without a CheckIn
VCR2054	appointment	Visit has a manual CheckOut without a CheckIn
VCR2055	appointment	Visit requires a modifier or includes a modifier that is not allowed
VCR2056	appointment	Cannot claim a cancelled appointment
VCR2057	appointment	CheckIn phone number only allowed for IVR CheckIns
VCR2058	appointment	CheckOut phone number only allowed for IVR CheckOuts
VCR2059	appointment	Missing provider medicaid id
VCR2060	appointment	Provider must have either NPI or API
VCR2061	appointment	Members 21 and older must have U3 modifier. Those under 21 must not
VCR2062	appointment	Rate exceeds max allowable rate
C2001	claim	Claim could not be rolled up due to in flight claims
C2002	claim	Appointment has 0 units to bill
G1000	NULL	Generic Error

This is a comprehensive list of CareBridge Pre-Billing validation responses – some may not be applicable to your specific integration.

Error Severity

The following list defines the possible types of error severity.

Severity	Description
ERROR	This is the standard error severity for pre-billing validations
WARNING	This can be used for less severe data issues (not currently in use)

Appointment Errors Report Specification

Appointment Errors Report File Specification

OVERVIEW

FILE FORMAT SPECIFICATIONS

NAMING CONVENTION

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