New claim edit: Zero-charge claims

Stedi now rejects 837P professional, 837D dental, and 837I institutional claims when the total claim charge amount is zero and the claim is marked as chargeable.

Most commercial payers do not accept zero-dollar claims. Some scenarios – such as capitated arrangements or encounter submissions – allow them, but standard chargeable claims must have a charge amount greater than $0. Otherwise, the payer will reject the claim, causing delays.

This edit  – the industry term for an automated validation rule – catches the issue before the claim reaches the payer.

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

{
  "errors": [
    {
      "code": "33",
      "description": "For Chargeable (CH) claims, the total claim charge amount $0.00 must be greater than zero ($0.00) dollars. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a 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.

Resolution tip
If the claim was intended for reporting and the total charge should be $0, change the claim’s Claim Identifier to Reporting. If you’re using a JSON claim submission API endpoint, you can do this by changing the top-level claimIdentifier request body property to RP (Reporting).