New EDI X12 Transaction edits in MIHMS

May 24, 2011

In the past, claims with provider-affiliation errors had been processed and denied. We have recently updated the system so that these claims are rejected at the initial EDI X12 transaction stage.

If you see the following messages on your Business Rejection Report (BRR):

  • No PayTo Affiliation Found.
  • No Service Affiliation from PayTo to Service Location Found.
  • No Service Affiliation from Rendering to Service Location Found.

You may need to make corrections to your provider enrollment. The error could be related to any of the following:

  • Rendering Provider affiliation to the Pay-To Provider.
  • Active Service affiliation from the submitted Pay-To Provider to the submitted Service Location.
  • Active Service affiliation from the submitted Rendering Provider to the submitted Service Location.

To correct these errors, please log into your Trading Partner account on the MIHMS online portal.

If you need more help, please contact the EDI Help Desk at 866-690-5585, Option 1. If you need help to update to your enrollment, contact Provider Enrollment at 866-690-5585, Option 2.