Certified on NPHIESGroupMissing documents
Who usually fixes itBilling, with the lab
Deadline15 days from the rejection
What it means
For example: A claim for a follow-up on diabetes is sent without the HbA1c result it refers to.
The rejection is about the claim as it was sent, not about whether the care was right.
Why it usually happens
- The result came back after the claim was sent.
- The result was recorded outside the visit.
- It wasn’t attached to the claim.
How to fix this claim
- Attach the result to the claim.
- Resend before the deadline.
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
Send a claim that depends on a result once the result is in.
This page explains the common causes. Your insurer’s policy and your contract decide each claim.
