What it means on your remittance
Pennsylvania found more than one EVV visit record matching this claim line, so it can't tell which one backs the service — and it denies rather than guessing. Its home-health twin is ESC 936. Common causes: visit files sent twice, and multi-worker overlap situations.
Why it happens
- The same visit was transmitted to the aggregator more than once — re-sent files are the classic cause.
- Two workers' visit records overlap in a way the matcher reads as duplicates (2:1 care situations).
- An alternate-EVV integration re-created a visit instead of updating the existing record.
How to fix it, step by step
- 1Find every visit record matching the claim line's client, service, and date in the aggregator.
- 2Identify the true visit and cancel the duplicates. Alternate-EVV users follow DHS's published mechanism: send an omission record with VisitCancelledIndicator=False that references the original VisitOtherID.
- 3Resubmit the claim once exactly one verified visit remains.
How to tell it apart
926/936 mean too MANY visits; 928/938 mean none. Both deny — Pennsylvania won't guess which duplicate is real.
Note: state edit codes like this one often appear on the paper Remittance Advice rather than inside the 835 file. If you only have the 835, our team can read the full remittance for you.
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Run the free Denial X-RayCommon questions
What does denial ESC 926 mean?
Pennsylvania found more than one EVV visit record matching this claim line, so it can't tell which one backs the service — and it denies rather than guessing. Its home-health twin is ESC 936. Common causes: visit files sent twice, and multi-worker overlap situations.
How do I fix a ESC 926 denial?
Remove or cancel the duplicate visit record. Alternate-EVV users: send an omission record with VisitCancelledIndicator=False referencing the original VisitOtherID, per DHS guidance. Then resubmit the claim.
Why would the state deny a claim for having too much evidence?
Because duplicates make the record ambiguous. If two visit records could each back the claim, an auditor can't tell which one is authentic — so the matcher refuses both rather than choosing.