Certified on NPHIESGroupMissing documents
Who usually fixes itThe nurse, before the doctor
Deadline15 days from the rejection
What it means
For example: An internal medicine visit is claimed with no blood pressure or pulse recorded.
The rejection is about the claim as it was sent, not about whether the care was right.
Why it usually happens
- The vitals weren’t recorded at the visit.
- They were written on paper but never entered.
- They weren’t sent with the claim.
How to fix this claim
- Add the vitals that were recorded at the visit.
- Resend the claim with them.
- If none were taken, never add them afterwards. Appeal only if the visit note shows why vitals weren’t needed; otherwise accept the rejection and fix the habit.
Mind the deadline. You have 15 days from the rejection to answer it (CHI Unified Health Insurance Contract, clause 5.4). Your contract with the insurer may set a different window, so check it.
How to stop it next time
Have the nurse record vitals before the doctor sees the patient, straight into the visit, not on paper, so they travel with the claim.
This page explains the common causes. Your insurer’s policy and your contract decide each claim.
