Are you a NY provider that after submitting a claim through Availity received following response codes: A7:21, A7:583, A7:476? Then this blog post is for you!

What is changing?

• As per Highmark- any professional claims for DOS 7/17/26 and thereafter will have pre-adjudication validation edit for proper number of billed charges and units for services rendered
• If your office receives Availity delayed payer  and electronic batch report the reason will be listed as Charges or Units exceed the standard values for the billed services.”
• The claim will be rejected and not adjudicated

Find this info useful? Follow my blog for more!

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• UHC: GI endoscopy advance notification and SOS update