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FMMIS Service Authorization Error Rejections

If a consumer’s service authorization comes back as rejected, double click the Service Authorization and scroll down to view the rejection reason. Below is a list of the rejection errors, descriptions, and resolutions.

06 - Recipient not Eligible

Consumer lost Medicaid eligibility before service authorization (SA) sent to FMMIS

Check consumer's eligibility and address the issues for eligibility to be restored

10 - Duplicate PA

There is another SA in FMMIS that overlaps with the newly created SA

Check FMMIS to see which PA needs to be addressed

75 - Sum of claims greater

SA allocation is lower than what the provider has billed on the PA in FMMIS

Check PA claims in FMMIS to see if the provider has over billed or increase the allocation on SA to at least the amount of the paid claims

79 - no description given

SA has been cancelled in ABC, but not in FMMIS due to the fact that the provider has billed against the PA

Check FMMIS to find the PA and re-create the SA in ABC. Email APD Help Desk with a request to have the PA number re-assigned. Address the issue of

whether or not the provider was authorized to bill

L3 - Line item not found

SA balance in FMMIS is zero

If funds were added to the SA, the provider needs to void the last paid claim. Then the SA needs to be re-sent to FMMIS to update the PA balance

L4 - Invalid authorized amount

Allocation on the SA is zero

Enter the correct allocation and re-send to FMMIS for PA number

L5 - Invalid unit rate

Unit rate on SA is zero

Enter the correct rate and re-send

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