Pre-Billing Validations

 

mceclip0.png

CareBridge EVV Integration - Pre-Billing Validations

The following is a full list of pre-billing checks performed in the CareBridge Platform that would prevent a claim from being generated in the CareBridge Platform and would be returned as an error to the vendor that submitted the visit to CareBridge.  The table below includes a comprehensive list of CareBridge Pre-Billing alert validation responses - some may not be applicable to your specific integration.  

Click on Entity Type to be taken to that section:

Appointment (VCR#) | Authorization (A#) | Caregiver (CG#) | Claim (C#) | Member (M#) | Provider (P#) 
| Member Address (MAD#) | Member Phone Number (MPN#) 

 

Error Code Entity Type Description

VCR1001

appointment Caregiver First Name is invalid.
VCR1002 appointment Caregiver Last Name is invalid.
VCR1003 appointment Caregiver License Number is invalid.
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 Manual Reason is not valid.
VCR1051 appointment Late Reason is not valid.
VCR1052 appointment Late Action is not valid.
VCR1053 appointment Missed Reason is not valid.
VCR1054 appointment Missed Action is not valid.
VCR1055 appointment Claim Action is not valid.
VCR1056 appointment MCO Id is not valid.
VCR1057 appointment ICN is missing or invalid.
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
VCR1098 appointment Caregiver Atypical ID is missing or invalid..
VCR1099 appointment Diagnosis Code must be valid ICD10 code.
VCR1100 appointment NPI does not exist on appointment.
VCR1101 appointment EVV Checkin Zip Code is not a valid zip code.
VCR1102 appointment EVV Checkout Zip Code is not a valid zip code.
VCR1103 appointment Manual Checkin Zip Code is not a valid zip code.
VCR1104 appointment Manual Checkout Zip Code is not a valid zip code.
VCR1105 appointment Location Start Zip Code is not a valid zip code.
VCR1106 appointment Location End Zip Code is not a valid zip code.
VCR1107 appointment Employee SSN is missing or invalid.
VCR1108 appointment Waiver Type is missing or invalid.
VCR1109 appointment Modifier 1 is not valid.
VCR1110 appointment Modifier 2 is not valid.
VCR1111 appointment Modifier 3 is not valid.
VCR1112 appointment Modifier 4 is not valid.
VCR1113 appointment Attending Provider First Name is missing.
VCR1114 appointment Attending Provider Last Name is missing.
VCR1115 appointment Attending Provider NPI is missing or invalid.
VCR1116 appointment Submitted Condition Code is invalid.
VCR1117 appointment Admission Date is missing or invalid.
VCR1118 appointment Patient Status is missing or invalid.
VCR1119 appointment Facility Type is not a valid type.
VCR1120 appointment Claim frequency is not a valid frequency code.
VCR1121 appointment Claim type is not a valid type.
VCR1122 appointment Referring Provider NPI is missing or invalid.
VCR1123 appointment Attending Provider Taxonomy Code is missing or invalid.
VCR1124 appointment Manual Checkin reason is not valid.
VCR1125 appointment Manual Checkout reason is not valid.
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.
VCR2004 appointment Billed units exceeds max units for authorization per period.
VCR2005 appointment Billed units exceeds daily max for HCPC.
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 exceeds actual units based on visit check in and check out times.
VCR2010 appointment Visit check in and check out are outside of authorization's effective dates.
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 Provider NPI does not meet requirements for a valid 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.
VCR2063 appointment Survey question external codes must be valid.
VCR2064 appointment Care task external codes must be valid.
VCR2065 appointment For procedure code 99509, members 21 and older must have HB modifier. Those under 21 must have a HA modifier.
VCR2066 appointment The most recent claim request has failed. View claim history for more information.
VCR2067 appointment Payer does not support sending voided claims.
VCR2068 appointment Member is not present in the payer's membership file.
VCR2069 appointment Appointment cannot be billed outside of the active claim window.
VCR2070 appointment Appointment overlaps with other scheduled appointments and does not appear to be a valid group visit.
VCR2071 appointment Payer does not support voiding externally.
VCR2072 appointment Missing employee on appointment.
VCR2073 appointment Visit contains invalid survey responses..
VCR2074 appointment Tax id on appointment does not match the tax id on the provider.
VCR2075 appointment Procedure code is not a valid code for this payer.
VCR2076 appointment Appointment can not cross midnight.
VCR2077 appointment Provider State Registration is missing.
VCR2078 appointment Provider is not active according to the state roster.
VCR2079 appointment Visit does not meet the duration requirements for the service code.
VCR2080 appointment Overnight appointments are not allowed.
VCR2081 appointment Revenue code is missing or is not a valid code for this payer.
VCR2082 appointment Visit location type is required for home health services.
VCR2083 appointment Provider billing settings are required.
VCR2084 appointment CareBridge is no longer accepting visits for this payer.
VCR2085 appointment Vendor does not support selected billing frequency.
VCR2086 appointment Payment is not guaranteed.
VCR2087 appointment Authorizations in a pending status cannot be billed.
VCR2088 appointment Visit does not contain a valid ICD-10 diagnosis code.
VCR2089 appointment This member has a PCSP that has not yet been acknowledged.
VCR2090 appointment Visit does not contain a valid primary diagnosis code.
VCR2091 appointment One or more billing settings need to be configured prior to billing this visit.
VCR2092 appointment Paid appointments cannot be cancelled.
VCR2093 appointment Claim type is required when billing on more than 1 claim type is enabled.
VCR2094 appointment Value code is not valid.
VCR2095 appointment Member DOB on visit does not match member's DOB.
VCR2096 appointment Start date can not be before admission date.
VCR2097 appointment If Value Code or Value Code Amount exists, both must be populated.
VCR2098 appointment Attending Provider NPI and Billing Provider NPI cannot be identical.
VCR2099 appointment IVR checkin must occur from an authorized member phone number
VCR2100 appointment IVR checkout must occur from an authorized member phone number
VCR2101 appointment Occurrence codes are not valid.
VCR2102 appointment Occurrence code dates are not valid
VCR2103 appointment Appointment does not contain the same number of valid occurrence codes and dates.
VCR2104 appointment Attending Provider Taxonomy Code is invalid
VCR2105 appointment This authorization is still in a pending status. Visits can be complete but not billed until the authorization is active.
VCR2106 appointment Employment Services are not approved for this visit.
VCR2107 appointment Provider alternate identifier is required for no auth visits.
VCR2108 appointment Visit is during a member hold. View Member Details for hold info.
VCR2109 appointment Member Deeming plan warning.
VCR2110 appointment T1019 services rendered after 12/31/2025 cannot be billed.
C1001 claim Taxonomy Code is required.
C1002 claim Payer Claim Number is required for adjusted claims.
C1003 claim Provider Medicaid ID is required.
C1004 claim Total Charges is required.
C1005 claim Provider address is missing or incomplete.
C2001 claim Claim could not be rolled up due to in flight claims.
C2002 claim Appointment has 0 units to bill.
C2003 claim Claim is not balanced.
C2004 claim Claim contains invalid durations for one or more billed services.
C2005 claim Claim line has partial units.
C2006 claim Primary diagnosis code is not a billable ICD-10 code.
C2007 claim Claim service dates don't cover line service dates.
C2008 claim Claim contains appointments with conflicting values for billing.
C2009 claim Claim line item control number is not unique.

CG1001

caregiver Employee First Name is missing or invalid.
CG1002 caregiver Employee Last Name is missing or invalid.
CG1003 caregiver Employee License Number is missing or invalid.
CG1004 caregiver Employee ID is missing or invalid.
CG1005 caregiver Employee Hire Date is missing or invalid.
CG1006 caregiver Employee Type is missing or invalid.
CG1007 caregiver Employee Gender is missing or invalid.
CG1008 caregiver Employee Date of Birth is missing or invalid.
CG1009 caregiver Employee Medicaid ID is missing or invalid.
CG1010 caregiver Employee Atypical ID is missing or invalid.
CG1011 caregiver Employee Zip is missing or invalid.
CG1012 caregiver Employee SSN is missing or invalid.
CG1013 caregiver Caregiver Username is missing or invalid.
G1000 NULL Generic Error

M1000

member Generic Error
M1001 member Medicaid ID is missing or invalid.
M1002 member First Name is missing or invalid.
M1003 member Middle Name is missing or invalid.
M1004 member Last Name is missing or invalid.
M1005 member Address Line 1 is missing or invalid.
M1006 member City is missing or invalid.
M1007 member State is missing or invalid.
M1008 member Zip is missing or invalid.
M1009 member Date of Birth is missing or invalid.
M1012 member Eligibility Start Date is missing or invalid.
M1013 member Eligibility End Date is missing or invalid.
M1014 member Eligibility end is in the past.
M1015 member Invalid member Medicaid ID.
M2001 member Member not associated to an authorization.
M2002 member Date of Birth is in the future.
M2004 member Member does not have active Medicaid eligibility 

P1000

provider Generic Error
P1001 provider Tax ID is missing or invalid.
P1002 provider Unique Identifier is missing.
P1003 provider Name is missing or invalid.
P1004 provider Address Line 1 is missing or invalid.
P1005 provider City is missing or invalid.
P1006 provider State is missing or invalid.
P1007 provider Zip is missing or invalid.
P1010 provider Submitter ID is missing or invalid.
P1011 provider Taxonomy Code is missing or invalid.
P1012 provider Must have either NPI or alt_NPI.
P1013 provider NPI is missing or invalid.
P1014 provider Provider end date is in the past.
P1015 provider Invalid NPI.
P1017 provider Medicaid ID is missing or invalid.
P1018 provider Provider has a PO Box address.
P1019 provider Zip is missing or invalid.
P1021 provider Atypical ID
P2001 provider Individual CDAC providers must have a Medicaid ID.

A1000

authorization Generic Error
A1001 authorization Authorization Reference Number is missing or invalid.
A1002 authorization Service Code is missing or invalid.
A1003 authorization Diagnosis Code is missing or invalid.
A1004 authorization Provider Unique Identifier is missing.
A1005 authorization Member Medicaid Id is missing.
A1006 authorization Effective Date is missing or invalid.
A1007 authorization Expiration Date is missing or invalid.
A1008 authorization Max Units is missing or invalid.
A1009 authorization Auth Limit Type is missing or invalid.
A1010 authorization Modifier 1 is missing or invalid.
A1011 authorization Modifier 2 is missing or invalid.
A1012 authorization Modifier 3 is missing or invalid.
A1013 authorization Modifier 4 is missing or invalid.
A1014 authorization Authorization end date is in the past.
A1015 authorization Attending Provider Name
A2001 authorization Authorization could not be matched to a provider.
A2002 authorization Authorization could not be matched to a member.
A2005 authorization Member is not eligible during the authorized time frame.
A2006 authorization Provider is not active during the authorized time frame.
A2007 authorization Cannot change members.
A2011 authorization No rate found for the procedure code.
A2012 authorization No unit definitions found for the procedure code.
A2014 authorization Authorization has multiple lines with different HCPC and modifier combinations in the same file.
A2015 authorization Authorization is not for CDAC services but is associated to an individual CDAC provider.
A2016 authorization Service Code is not valid.
A2017 authorization Invalid NPI.
A2018 authorization Members 21 and older must have U3 modifier. Those under 21 must not.
A2019 authorization Rate exceeds max allowable rate.
A2020 authorization Diagnosis Code must be valid ICD10 code.
A2021 authorization Rate is missing.
A2022 authorization Invalid service type for member over 21.
A2023 authorization Service code is not in the list of authorized services.
A2025 authorization Attending Provider NPI does not meet requirements for a valid NPI.
A2024 authorization Attending Provider must have either NPI or AltID.
A2026 authorization Provider Secondary ID required for procedure code.
A2027 authorization An authorization for a corresponding service does not exist.
A2028 authorization Authorization limit type is not allowed.
A2029 authorization Rate conflicts with one or more authorizations.
A2030 authorization Authorization Reference Number is missing Line Identifier.
A2031 authorization Max Units Per Partition calculation not evenly divisible.
A2032 authorization Authorization contains an invalid taxonomy code for the service code.
A2033 authorization Diagnosis code cannot be billed as a primary diagnosis code.

MAD1001

member address Transaction ID is missing or invalid
MAD1002 member address Transaction DateTime is missing or invalid
MAD1003 member address Provider Name is missing or invalid
MAD1004 member address Provider Tax ID is missing or invalid
MAD1005 member address Member Medicaid ID is missing or invalid
MAD1006 member address Member ID is missing or invalid
MAD1007 member address Street Address is missing or invalid
MAD1008 member address Street Address 2 is missing or invalid
MAD1009 member address City is missing for invalid
MAD1010 member address State is missing or invalid
MAD1011 member address Zip is missing or invalid
MAD1012 member address Deleted Record is invalid
MAD1013 member address Inactive Record is invalid
MAD1014 member address MCO ID is missing or invalid 
MAD2001 member address Member address/phone number could not be matched to a provider.
MAD2002 member address Member address/phone number could not be matched to a member.
MAD2003 member address Member Medicaid ID and Member ID are missing; at least one is required
MAD2004 member address Request to delete address/phone number does not reference an existing address/phone number
MAD2005 member address Request to inactivate address/phone number does not reference an existing address/phone number

MPN1001

member phone Transaction ID is missing or invalid
MPN1002 member phone Transaction DateTime is missing or invalid
MPN1003 member phone Provider Name is missing or invalid
MPN1004 member phone Provider Tax ID is missing or invalid
MPN1005 member phone Member Medicaid ID is missing or invalid
MPN1006 member phone Member ID is missing or invalid
MPN1007 member phone Member Home Phone Number is missing or invalid
MPN1008 member phone Deleted Record is invalid
MPN1009 member phone Inactive Record is invalid
MPN1010 member phone MCO ID is missing or invalid 
MPN2001 member phone Member address/phone number could not be matched to a provider.
MPN2002 member phone Member address/phone number could not be matched to a member.
MPN2003 member phone Member Medicaid ID and Member ID are missing; at least one is required
MPN2004 member phone Request to delete address/phone number does not reference an existing address/phone number
MPN2005 member phone Request to inactivate address/phone number does not reference an existing address/phone number