Remark Codes
What does remark code CO-45 stand for?
What is: OVER CONTRACTED FEE ARRANGEMENT (Contractual).
Which payer has the P82 Denials?
What adjustment code would you use when further follow up is cost prohibitive?
What is: Follow Up Unwarranted (Code 437)
Who is Stevie?
Who is: Jessica's Dog
What does remark code CO-16 stand for?
What is: LACKS INFO NEEDED FOR ADJUDICATION (Missing Information)
Which payer has the Point of Service Denials?
Who is: Tricare
What adjustment code would you use when an account has not been followed up on by staff for a long time usually > 6 months?
What is: Follow Up Time Period Expired (509)
Who is Marley?
Who is: Stephanie's daughter
What does remark code CO-242 stand for?
What is: SERVICES NOT PROVIDED BY NETWORK/PRIMARY CARE PROVIDERS
Which payer requires a service #, prior to a reconsideration being submitted?
Who is: Kaiser
What adjustment code would you use when an additional procedure was added to a surgery that wasn't on the planning sheet?
What is: No Auth- Unscheduled Service ( Code 235)
Which co-worker announced their pregnancy last year?
Who is: Elizabeth
What is: INFO REQST FROM BILLING PROV (Missing information from Provider)
Which payer has a new internal claims escalation team?
Who is: Regence
What is: Payor Packaged Services (Code 203)
How many sisters does Kenzie have?
What is: 7 sisters
What does remark code CO-20 stand for?
What is: DENIED, COVERED BY LIABILITY CARRIER
(TPL)
Which payer, has the customer service rep with chickens?
Who is: Regence or Aetna
What adjustment code would you use to adjust the remaining balance after invoicing between 2 payers? (Accounts will be escalated first depending on the process flow.)
What is: Payer Invoiced Adj (Code 446)
How many pets does Stephanie have?
What is: 2 pets