Service Line Limitations

Have you ever received a denial for Explanation of Benefits (EOB) 00237- TOTAL BILLED DOES NOT EQUAL THE SUM OF DETAILS BILLED?

NCTracks records show claims commonly deny for this reason, on paper claims only, because of line limitations on claim formats. This does not apply to electronic claims. To prevent this from happening on paper claims, it is important that you ensure that each item billed corresponds to a single claim line. 

• When submitting a paper claim with multiple pages, each page is recognized in the NCTracks system as a separate claim. 
• Each claim form submitted should be totaled to correspond to the line items on each individual page/form. Meaning, that since there are only six lines available on a paper claim form, claims with more than six line items must submit another claim page(s) with the additional line(s) and the claims' corresponding documentation. 

Keep in mind, there are line limitations on all forms of claim types. Please reference the table of limitations below:

	Claim Format
Claim Type	Paper format Line Limit	ASCX12 Line Limit	Provider Portal Direct Entry Line Limit
Professional	6 (CMS-1500)	50 (837Professional)	50
Institutional	22 (UB-04)	999 (837Institutional)	999
Dental	10 (ADA2012)	50 (837Dental)	50

When submitting an online claim, the lines are created for you through a series of data requests creating an easier process for accurate claim submissions.

If additional help is needed, training courses are available via SkillPort – the NCTracks Learning Management System. For more information on these trainings and to see upcoming training opportunities please refer to the Provider Training page of the public Provider Portal on the NCTracks website. 

Other claim resources are available on the NCTracks website on the public Provider Portal page under the Claims section.