Correcting and resubmitting claims rejected for member ID match error
If you see a claim rejected for “Member ID does not match a Priority Health member”, you can correct the claim and rebill.
What to look for
Review the following information on your rejected claim to find which field(s) didn’t match the member seen and caused the rejection:
- Member ID (between 8-12 digits, including any dash / suffix)
- First name (including any special characters or spaces)
- Last name (including any special characters or spaces)
- Date of birth
- Gender
You can verify this information against the member’s ID card or through Member Inquiry in prism.
Resubmitting the claim
Because claims rejected for “Member ID does not match a Priority Health member” are rejected in full (zero dollars allowed), you should make the appropriate changes and resubmit as a new claim. Don’t submit as a corrected claim.
Find instructions below for resubmitting claims: