Edit 02046


Supervising MMIS Provider ID Cannot be Derived

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N297
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: N/A

Potential Causes:
The supervising provider’s MMIS Provider ID cannot be derived from the supervising provider’s NPI.

Solution:
The NPI of the supervising provider that was entered on the claim is not on file with NYS Medicaid. Check the NPI used to ensure the correct NPI was entered on the claim. If the correct NPI was entered contact the NYS Medicaid enrollment unit at 518-402-7032 for fee for service claims.

837 Professional

Loop 2310E NM1 (Supervising Provider Name) NM109 (Supervising Provider Primary ID) - or - Loop 2420D NM1 (Supervising Provider Name) NM109 (Supervising Provider Primary ID)