Correcting Rejected Fee-For-Service Bills

The Department processes individual case information and fee-for-service bills every week. Files received by 5:00 p.m. on Monday are processed that week and sent to the Comptroller for processing by the following Monday. Files received after the deadline are processed during the next weekly cycle.

Below is a list of the most common reasons bills for developmental disabilities services that are rejected, along with a brief description.To see the recommendations for correcting and transmitting the bills, select the error code needed, which is a link to the recommendations. 

After correcting these problems, rejected bills must be re-transmitted to DHS.

Reject Code Description
14  14 : Administrative Hold
55  55 : No ROCS case opening found for individual
56  56 :All fee-for-service programs are terminated for SSN
See Reject Code 75 for correction guidance 
6P  6P : Individual is in the Aging Community Waiver
6Q  6Q : Individual is in DRS Waiver (brain injury, AIDS, physical disability)
6R 6R : Individual is in the DSCC Children's Waiver
6S 6S : Individual is in the Supportive Living Waiver
61 61 : Name mismatch with HFS Medicaid
65 65 : Service dates overlap with another bill
67  67 : Provider not enrolled as waiver provider for the service
7A  7A : Individual SSN not authorized for this program
See Reject Code 75 for correction guidance.
7B 7B : Bill includes dates before or after authorized dates
7C  7C : Program authorized at a different provider
71 71 : Bill exceeds monthly combined maximum (HBS)
72 72 : Appropriate professional credentials not on file
73  73 : Program exceeds fiscal year maximum
74  74 : Program exceeds combined fiscal year maximum or bedhold max
75 75 : No fee-for-service ever authorized for SSN
86  86 : ROCS case opening lacks income information for service date
9B  9B : NPI not on file for service provider
9C Foster Care - Not Eligible for DD Child Waivers
9D Ineligible type of Medicaid enrollment-Contact ISC for New Application
95 95 : Individual not enrolled in Medicaid
96  96 : RIN lacking or incorrect in ROCS
97  97 : Individual does not need active treatment
98  98 : Active treatment field is blank or service date is before active treatment effective date
99  99 : No current waiver redetermination