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Rejected by Jopari. Status Message: A7 - Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected.; 364 - Is accident/illness/condition employment related?

Rejection Message Rejection Details Resolution

Rejected by Jopari. Status Message: A7 - Acknowledgement/Rejected for Invalid Information - The claim/encounter has invalid information as specified in the Status details and has been rejected.; 364 - Is accident/illness/condition employment related?

 

 

This rejection indicates that the claim failed Jopari's validation. The insurance program on the claim does not match the condition.

Submitter Action:

Verify that the condition in the patient case for the claim matches with the insurance program.

If the condition is related to "Employment", the insurance program will need to be "WC - Workers Compensation Health Claim."

If the condition is related to an "Auto Accident", the insurance program will need to be "AM - Automobile Medical."

If the practice submits claims for both Workers Compensation Health Claim and Automobile Medical, please ensure that separate insurance companies and insurance plans are created for each. One specifically for Workers Compensation and one specifically for Automobile Medical.

 

 

 

 
Follow the instructions below to verify the condition:
  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. Double-click on the Case.
  4. Click on the Condition tab.
  5. Check the appropriate condition box in the “Condition related to” section.
    • Auto Accident? = AA
      • Select where the accident occurred from the State dropdown.
    • Employment? = EM
  6. Add the accident date for an auto accident:
    • In the Date Type drop-down menu, select the “Accident Date."
    • In the Start Date field, enter or select the date in the drop-down menu.
    • In the End Date field, enter or select the date in the drop-down menu (if applicable).
    • Click on the Add button to populate the date to the field below.
  7. Or add the date of injury for employment:
    • In the Date Type drop-down menu, select the “Date of Injury."
    • In the Start Date field, enter or select the date in the drop-down menu.
    • In the End Date field, enter or select the date in the drop-down menu (if applicable).
    • Click on the Add button to populate the date to the field below.
  8. Click Save all the way out (multiple saves may be required). 

Then follow these instructions to verify the insurance program:

  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. Double-click on the Case.
  4. Double-click on the Insurance Policy related to the workers compensation.
  5. Double-click on the Insurance Name to open the Edit Insurance Plan page.
  6. Double-click on the Insurance Company name to open the Edit Insurance Company page.

**Note: Any changes made on the Edit Insurance Company settings will apply to ALL insurance policies and plans within the practice tied to that insurance company.**

  1. Change the Insurance Program to appropriate one.
    • If the condition in the case was marked as "Auto Accident", select "AM - Automobile Medical". 
    • If the condition in the case was marked as "Employment", select "WC - Workers Compensation Health Claim".
  2. Click Save all the way out (multiple saves may be required).

Then, rebill and resubmit all affected claims.