How to correct Payer ID# and Payer Name error in Inovalon?

Purpose:

To provide a step-by-step guide for resolving payer identification mismatches in Inovalon clearinghouse, ensuring accurate claims submission and reducing billing rejections.

Scope:

This article covers:

1. Locating correct payer IDs through Inovalon's lookup tool
2. Seven-step process to fix "Payer Not Matched" errors
3. Updating payer information in box 11C 
   Excludes:
4. Other clearinghouse error types
5. Initial payer setup
6. Bulk payer updates

Procedure:

1. Identify Correct Payer ID:
   1. Use Inovalon Payer ID Lookup
2. Correct Mismatch (Box 11C):
   1. Click dropdown arrow by insurance name
   2. Enter correct Payer ID > Enter
   3. Select verified payer > Apply
3. Validate Match:
   1. Click magnifying glass icon
   2. Create new match with:
      1. Field: Payer Name/ID
      2. Match type: Exact
   3. Save > Save and Validate

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You can find the payers ID specific to the clearinghouse here Inovalon Payer ID Lookup | Search Payer IDs by Claims & Eligibility .

How To Fix The Payer Not Matched and Media Code Error In Inovalon

Step 1 – Scroll to box 11C and click on arrow beside insurance name

Step 2 – Input Payer ID for the insurance and click “Enter”

Step 3 – Select correct payer code and click “Apply”

Step 4 – Click the magnifying glass icon on box 11C

Step 5 – On new tab, Click “new match” > add field > click “exact” under match type

Step 6 – Select payer and click “Save”

Step 7 – Click “Save and Validate”