PI-B7
Provider not certified/eligible to be paid for this service on this date
What This Code Means
The payer’s records show the rendering provider wasn’t certified, credentialed, or eligible to bill this specific service on the date billed.
Common Causes
- Provider credentialing with this payer not yet finalized
- Provider's specialty/taxonomy code doesn't match the service billed
- Provider was out-of-network on the date of service
How to Resolve or Appeal
- Confirm credentialing/enrollment status with the payer as of the date of service
- Correct the rendering provider or taxonomy code if entered incorrectly
- Appeal with proof of active credentialing if the payer's records are wrong
More Denial Codes to Check
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.