Please Note: There is no Medicare information on our corporate website. Please select a specific contract in the 'Search Within' box for Medicare related information.
© 2021 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
Printed Date: 9/22/2015
Problem: Missing beneficiary name. Please make corrections and resubmit.
Effective with the September 2010 system release, the beneficiary's name must be entered on page one of claim. The beneficiary info no longer auto-populates on pages one and five of the claim after entered on claim entry screen.
Explanation and Suggestions
Providers who enter claims directly in the Fiscal Intermediary Standard System (FISS) (referred to as direct data entry, or DDE) are required to enter in the patient’s last name and first name, in addition to the Health Insurance Claim Number (HICN), on FISS Page 01. This has always been a requirement for DDE. However, a recent edit was installed to ensure the patient’s name is keyed by the provider. If a claim is keyed into DDE and is missing the last and/or first name on FISS Page 01, the claim will be returned to the provider (RTP) with reason code 16501. Please ensure that your billing staff is aware of this new editing, and are keying the patient’s name into FISS Page 01 as required.
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 01/11/2018