Claim edit: Invalid billing provider ZIP Code

Stedi now rejects 837I institutional claims that include an invalid billing provider ZIP Code.

Institutional claims must include a full nine-digit ZIP Code – called a ZIP+4 – with no spaces or hyphens for the billing provider. For example: 100031502. If you don’t know the full ZIP+4, you can look it up using the USPS ZIP Code Lookup tool.

If you submit institutional claims through Stedi’s institutional claim submission JSON API endpoint, this ZIP Code is provided in the providers.address.postalCode field.

Payers reject claims that are missing a full ZIP+4 or that contain an invalid code, which can cause delays.

This edit – the industry’s term for an automated validation rule – prevents these claims from reaching the payer.

Rejection errors
If you submit a claim that fails the edit using Stedi’s institutional claim submission API, you’ll get back an error message in real time. If you’re using the JSON API endpoint, the response includes an error in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "The Billing provider ZIP Code, 11113527, is invalid. ZIP Codes must be a nine-digit number with no spaces or hyphens. Correct and resubmit",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit an institutional claim that fails the edit using SFTP, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will contain a related claim status category code, claim status code, and error message. You can use the error message to correct and resubmit the claim.