Medicare AdvantageAdministrativeMedium impact
20-465 Changes and Clarifications to Reject Codes 76, AK and C6
Health Net·CA·Reimbursement
We identified it
Jun 20, 2026
Summary
Health Net has clarified requirements for three common reject codes: 76 (corrected claims must reference original claim number in box 64/22 with frequency code 7 or 8), AK (leave original reference boxes blank for new claims), and C6 (attach other insurance EOB with specific fields completed for Cal MediConnect members). The policy also outlines guidelines for timely filing waivers when providers can show good cause for delays.
Action Required
Immediately: Billing team must update claim submission procedures for Health Net rejections. For reject code 76 (corrected claims): Enter original claim number in UB-04 box 64 or CMS-1500 box 22, use frequency/resubmission code 7 or 8, no punctuation or special characters. For reject code AK (new claims): Leave boxes 64 and 22 completely blank. For reject code C6 (Cal MediConnect with other insurance): Complete fields 9, 9a, 9d, mark 'yes' in 11d, and attach other insurer's EOB. Train staff on good cause guidelines for timely filing appeals when delays were due to member misinformation or unforeseen circumstances beyond provider control.