Claim errors
Codes any exchange call can meet are recorded once, in the Other specification: the gateway's NHCX- codes, the standard payer codes, and the reference payer's structure and transport codes. The reference payer's other codes sit with the exchange they reject: coverage eligibility, preauthorisation, claim and insurance plan. Reading error codes explains the code spaces.
Reference Payer codes
Reference payer codes, PAYR-1001 to PAYR-1520. Sent by the PMJAY reference implementation; they arrive inside the sealed response.
The SHA HP sandbox sent this code as "Active instance found for case number", for a second request on a case while the first was still queued. The sheet's message reads the opposite way.
| Code | Message |
|---|---|
PAYR-1322 | No active case found for the given case number. |
Unclassified
The rule that reads the message could not classify these. Read the message and decide.
| Code | Message |
|---|---|
PAYR-1301 | Claim has already been raised for case number %s. Hence new claim request will not be accepted. |
PAYR-1302 | No preauthorization approved record found for case number %s. Hence new claim request will not be accepted. |
PAYR-1303 | No active claim record found for case number %s. Hence query updation request will not be accepted. |
PAYR-1304 | No claim queried record found for case number %s. Hence query updation request will not be accepted. |
PAYR-1305 | Invalid usecase requested for case number %s. Please try again with valid usecase. |
PAYR-1306 | No item found in preauthorization request for procedure %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1307 | Invalid quantity requested for procedure %s with item sequence %s for case number %s. Please try again with valid quantity. |
PAYR-1308 | No item found in active claim request for procedure %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1309 | No item found in preauthorization request for implant %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1310 | Invalid quantity requested for implant %s with item sequence %s for case number %s. Please try again with valid quantity. |
PAYR-1311 | No item found in active claim request for implant %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1312 | No item found in preauthorization request for investigation %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1313 | Invalid quantity requested for investigation %s with item sequence %s for case number %s. Please try again with valid quantity. |
PAYR-1314 | No item found in active claim request for investigation %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1315 | Rejected item found for preauthorization for procedure %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1316 | Rejected item found for preauthorization for investigation %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1317 | Rejected item found for preauthorization for implant %s with item sequence %s for case number %s. Please try again with valid items. |
PAYR-1318 | No requested treatment plan found for case number %s. Please try again with valid items. |
PAYR-1319 | No requested investigation plan found for case number %s. Please try again with valid items. |
PAYR-1320 | No details found for the requested investigations in the system. Hence request will not be processed. |
PAYR-1321 | Error occurred while processing the request due to invalid workflow id as (%s) |
PAYR-1323 | Insufficient wallet balance. Hence the request will not be processed. |
PAYR-1324 | Invalid discharge stage received for case number %s. Hence the request will not be processed. |
PAYR-1325 | Invalid admission date received for case number %s. Hence the request will not be processed. |
PAYR-1326 | Invalid discharge date received for case number %s. Hence the request will not be processed. |
PAYR-1327 | Invalid admission date format received for case number %s. Hence the request will not be processed. |
PAYR-1328 | Invalid discharge date format received for case number %s. Hence the request will not be processed. |
PAYR-1329 | Invalid registration date received for case number %s. Hence the request will not be processed. |
PAYR-1330 | Invalid registration date format received for case number %s. Hence the request will not be processed. |
PAYR-1331 | Receiver not registered in NHCX. Please try again with valid receiver details. |
PAYR-1332 | Invalid CRC request. |
PAYR-1333 | Invalid claim type (in-patient/out-patient) received. Hence the request will not be processed. |
PAYR-1334 | Hospital configuration not found. Please contact support team. |
PAYR-1335 | Invalid implant quantity received as %s for implant %s for case number %s. Please try again with valid data. |
PAYR-1336 | Invalid implant unit price received as INR %s for implant %s for case number %s. Please try again with valid data. |
PAYR-1337 | Invalid implant net amount received as INR %s for implant %s for case number %s. Please try again with valid data. |
PAYR-1338 | Invalid implant attachment received for investigation %s for case number %s. Please try again with valid data. |
PAYR-1339 | Invalid implant status received as %s for investigation %s for case number %s. Please try again with valid data. |
PAYR-1340 | Invalid investigation status received as %s for investigation %s for case number %s. Please try again with valid data. |
PAYR-1341 | Invalid investigation attachment received for investigation %s for case number %s. Please try again with valid data. |
PAYR-1342 | Existing case in progress found for case number %s. Hence new reimbursement request will not be accepted. |
PAYR-1343 | Previous reimbursement approved record found for the new reimbursement request for case number %s. Hence request will not be processed further. |
PAYR-1344 | No details found for the requested procedures in the system. |
PAYR-1345 | Invalid procedure status received as %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1346 | Invalid procedure description received as %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1347 | Invalid procedure type received as %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1348 | Invalid procedure factor received as %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1349 | Invalid procedure quantity received as %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1350 | Invalid procedure net amount received as INR %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1351 | Invalid speciality code received as %s for procedure %s for case number %s. Please try again with valid data. |
PAYR-1352 | Requested beneficary details and careplan details does not match any criteria for processing the case at this hospital. Please try again with valid data. |
PAYR-1353 | Invalid careplan id received. Please try again with valid careplan id. |
PAYR-1354 | Rule failure. |
PAYR-1355 | No details found for the requested implants in the system. Hence request will not be processed. |
PAYR-1356 | Patient liability is not aplicable for the hospital and beneficiary do not have enough wallet balance with deficit amount INR %s for the requested preauthorization for case number %s. |
PAYR-1357 | Admission date cannot be after the discharge date. Hence request will not be processed. Please correct the data and try again. |
PAYR-1358 | Registration of the patient is allowed maximum upto %s days after admission. Hence request will not be processed. Please correct the data and try again. |
PAYR-1359 | No billable treatment plan received for case number %s. Please try again with valid treatment plan data. |
PAYR-1360 | Invalid item code received as %s for item sequence %s case number %s. Please try again with valid data. |
PAYR-1361 | Invalid item sequence received as %s for case number %s. Please try again with valid data. |
PAYR-1362 | No procedure with code LM100 received with 'Requested' status for case number %s. Please try again with valid data. For PMJAY claims, if case comes under LAMA/DAMA scenario with beneficiary being discharged before surgery or during surgery, procedure with code LM100 is mandatory. Only this procedure code will be accepted for LAMA/DAMA case, and all other previous preauthorization approved items will get disqualified for the claim submission |
PAYR-1363 | Response for Authentication Consent Questionnaire is missing for case number %s. This must be sent if the biometric authentication for patient is not available during discharge. For new claim request, either biometric authentication for patient during discharge, or response for Authentication Consent questionnaire must be sent. Please check/update the insurance plan for the policy for the details of the questionnaire. |
PAYR-1364 | No value received for link id %s for Authentication Consent Questionnaire for claim request. This must be sent if the biometric authentication for patient is not available during discharge. For new claim request, either biometric authentication for patient during discharge, or response for Authentication Consent questionnaire must be sent. Please check/update the insurance plan for the policy for the details of the questionnaire. |
PAYR-1365 | Response for STG Questionnaire id %s is mandatory for procedure code %s. Hence the preauthorization request will not be processed as the questionnaire response is not received for procedure code. |
PAYR-1366 | Invalid biometric user token received. Please try again with valid biometric details of the beneficiary. For any issues with biometric, please try with Authentication Consent Questionnaire for discharge, details for which has been received in insurance plan. |
PAYR-1367 | No biometric records found for the beneficiary for %s. Please ensure correctness of biometric authentication date for the day for cyclic procedure %s. |
PAYR-1368 | %s units of cycle information received for procedure code %s with item sequence %s. Cycle information should be sent for all the requested/processed cycles. |
PAYR-1369 | Biometric authentication cannot be performed more than once on the same date. Multiple biometric authentication information has been provided for same date for cyclic procedure %s. Hence case will not be processed. Please check and update biometric authentication execution dates and try again. |
PAYR-1370 | Received invalid start date as %s for supporting details with item sequence %s. Please try again with valid start date. |
Every code above is recorded in the specification that owns it. The aggregated list across modules is at error codes.