Denial Codes
Claim denial code that applies when care may be covered by another payer per coordination of benefits.
CO-22
Claim denial code that applies when payment is adjusted because charges were not submitted timely
CO-23
What is the reward you win for first place in the top performer competition?
A $60 gift card and 1x entry into the end-of-year raffle
The deadline by which a claim must be submitted to the insurance company for payment. Missing this window usually results in denial.
Timely Filing
What is the name of the famous red-nosed reindeer?
Who is Rudolph
Claim denial code that applies when services are not covered because they are not deemed medically necessary
CO-50
Not a denial code, but a unique code identifying a specific medication for billing.
National Drug Code (NDC)
What is the reward for the end-of-year raffle winner?
A $100 gift card or a prize of the same value!
A requirement that a service or procedure is clinically appropriate and necessary for the patient’s condition, as determined by insurance guidelines.
Medical Necessity
What are the two proteins traditionally served at Thanksgiving and Christmas, respectively?
Turkey and ham
Claim denial code that applies when the charge exceeds fee schedule/maximum allowable amount.
CO-45
Claim denial code that applies when there is a duplicate claim/ service
CO-18
What do we call the two groups of team members, separated into who joined when and what payers they work on?
Cohort 1 and Cohort 2
Not a denial code, but a code that classifies a provider’s specialty for billing purposes.
What is the name of the popular Christmas ballet featuring characters like Clara and the Sugar Plum Fairy?
The Nutcracker
Claim denial code that applies when there are non-covered charges
CO-96
DAILY DOUBLE!
Claim denial code that applies when an attachment/ other documentation is required to adjudicate this claim/ service
CO-252
What gives you an entry into the end-of year raffle? Must provide all 4 eligible entries.
Placing 1st, 2nd, or 3rd in the Top Performer Competition, and/ or a 95% or higher audit score!
The process of determining which insurance plan pays first when a patient has multiple coverages.
Coordination of Benefits (COB)
What are the four or five items traditionally used to decorate a snowman?
Top hat, carrot for nose, sticks for arms, and a scarf!
Claim denial code that applies when benefit maximum for this time period or occurrence has been reached.
CO-119
Claim denial code that applies when the patient cannot be identified as our insured
CO-31
What is the name of the director of outpatient business at Brooks?
Natalie Odueke
A type of insurance plan that requires using network providers and referrals.
Health Maintenance Organization (HMO)
What is the location of the longest ongoing annual tree display known for having the tallest tree in the country?
Rockefeller Center