Character Limits for eClaims
You will encounter errors and rejections if you exceed the character limits for electronic claims. Here is a guide help you identify and correct these errors!
Remarks Field (box 35)
- 80-character limit (this is a temporary character limit and will be updated to 400 characters in the near future)
- To see this field, right-click on the claim and select Edit Claim
IMPORTANT: If an eClaim exceeds the Remarks character limit, it will appear in Tops with a Clearinghouse Rejected status; HOWEVER, the claim will not appear in the Rejected by Clearinghouse status filter. It will appear in Unpaid>Open Claims Only and will not show an error indicator. You will need to void the claim, and pull a new claim, limiting the Remarks comments to a maximum of 80 characters. If the claim submits successfully, it will appear in the Accepted by Clearinghouse status filter.
As of Tops v9.11.0, the Remarks field has an 80 character limit. For initial claims, this leaves 21 characters available after 59-characters are used for detailing the initial fee and monthlies in an initial claim. This is a temporary character limit and will be updated to 400 characters in the near future.
Brief Description field
- 80-character limit
- To see this field, right-click on the claim and select Edit Claim
Billing Entity Name (box 53)
- 35-character limit
Pay-to Entity Name (box 48)
- 35-character limit
Pay-to NPI (box 49)
- 80-character limit
- Cannot be fewer than 2 characters
Employer Policy group number (box 16)
- 30-character limit
Policy Holder's Street Address (box 12)
- 55-character limit
Patient's Street Address (box 20)
- 55-character limit
Insurance Company's Address (boxes 3 and 11)
- 55-character limit
Insurance Company's Name (boxes 3 and 11)
- 25-character limit
Policy Holder's First Name (box 12)
- 25-character limit
Policy Holder's Last Name (box 12)
- 35-character limit
Policy Holder's Middle Name (box 12)
- 25-character limit
Policy Holder's Suffix (box 12)
- 10-character limit
Policy Holder's Identification Code (box 15)
- 80-character limit
- Cannot be fewer than 2 characters