MedicaidAdministrativeMedium impact
20-466 Changes and Clarifications to Reject Codes 76, AK and C6
Health Net·CA·Reimbursement
We identified it
Jun 20, 2026
Summary
Health Net clarified requirements for three common reject codes affecting Medi-Cal claims in Fresno, Kings and Madera counties. Key changes include specific formatting rules for original claim numbers (reject code 76), leaving reference fields blank for new claims (reject code AK), and proper attachment of other insurance EOBs for secondary claims (reject code C6).
Action Required
Immediately: Billing team must update claim submission procedures for Medi-Cal claims in Fresno, Kings and Madera counties. For corrected claims (reject code 76), ensure original claim number is entered in UB-04 box 64 or CMS-1500 box 22 with frequency/resubmission codes 7 or 8 only. For new claims (reject code AK), leave these reference boxes blank. For secondary claims (reject code C6), complete fields 9, 9a, 9d, mark 'yes' in 11d, and attach other insurer's EOB. Train staff on good cause documentation for timely filing appeals when delays are due to member misinformation or unforeseen circumstances.