B7: This provider was not certified/eligible to be paid for this procedure/service on this date of service
On Call Scenario:
Claim denied as This provider was not
certified/eligible to be paid for this
procedure/service on this date of service
↓
May I get the denial date?
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What is the exact issue?
↙ ↓ ↘
The rendering provider The referring provider The procedure code is inconsistent
is not eligible to perform is not eligible to refer with the provider type/specialty
the service billed the service billed or taxonomy code is invalid
↓ ↓ ↓
Click Here Click Here Click Here
Important Note:
Claim denied as This provider was not
certified/eligible to be paid for this
procedure/service on this date of service
↓
May I get the denial date?
↓
What is the exact issue?
↙ ↓ ↘
The rendering provider The referring provider The procedure code is inconsistent
is not eligible to perform is not eligible to refer with the provider type/specialty
the service billed the service billed or taxonomy code is invalid
↓ ↓ ↓
Click Here Click Here Click Here
Important Note:
- Click on the link to follow a specific scenario.
In this Denial of B-7 , there can be issue of contract / Credential termination. Pls add this too.
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