PAYMENT PROCESSING
THE UB CLAIM IS BILLED WITH REV CODE ONLY LINES AND THEY ARE NOT PRICING.
WHAT IS DENY 672 FOR PACKAGED SERVICE?
YOUR CLAIM HAS A TOB OF 135
WHAT IS DENY TOB AND ADD REWORK MNEMONIC
WITH CORRECTED CLAIM LETTER
RWKUPHMM/DD/YYYY
[INSERT COMMENT]
NOTES STATE CONTRACTUAL DENIAL PER EVICORE.
(REVIEW SECONDARY/ ADD ON CODES)
WHAT IS DENY MSI? (CODE SPECIFIC)
YOU SEE A QRP OR A 603 PEND ON A CLAIM
YOU HAVE A 329 CLAIM WITHOUT A 322 CLAIM ON FILE.
WHAT IS DENY 329 WITH RA4?
A NON-PAR AMBULANCE CLAIM IS PRICING FOR MORE THAN BILLED, WHAT DOES NOT APPLY?
WHAT IS LESSER OF LANGUAGE?
TOB 851 AND THE CONTRACT IS CONFIGURED TO APPLY 43% OF BILLED CHARGES
WHAT IS PROCESS PER SYSTEM LOAD?
YOU HAVE AN OUTPATIENT CLAIM WITH AN AUTH THAT STARTS WITH IP
WHAT IS REVIEW THE AUTHORIZATION?
YOU NEED TO RETRACT THE CORRECTED CLAIMS LETTER SENT IN ERROR.
WHAT IS ADD THE NOTATION NOTRWKUPHDD/MM/YYYY
CLAIM IS RECEIVED FROM WEBSTRAT WITH PRICING ATTACHED
WHAT IS MAKE SURE CLAIM WAS SENT FOR PRICING CORRECTLY AND REVIEW PRICING SHEET?
TOB FOR FQHC
WHAT IS TOB 77X?
YOU HAVE AN INAPTIENT CLAIM AND THE CLAIM HAS BOTH A DENIED INPATIENT AUTHORIZATION AND AN APPROVED OUTPATIENT AUTHORIZATION
WHAT IS ATTACH INPATIENT AUTHORIZATION AND DENY PER?
YOU HAVE A PAPER CLAIM
WHAT IS CHECK DATA ENTRY IN DOCDNA?
YOUR TOB IS 329 AND THE HISTORY SEARCH SHOWS A 322 ON FILE DENIED WITH RA2. THE 329 IS BILLID WITHOUT A HIPPS CODE.
WHAT IS MARK UNCLEAN AND DENY 622?
HSS AND WEBSTRAT CANNOT PRICE AND THE MEDICARE ID HAS BEEN VERIFIED WITHIN A 30 DAY TIMEFRAME AND DETERMINED MISSING/INVALID/CLOSED.
WHAT IS DENY UBI AND NOTATE?
YOU HAVE A TOB 117 IN HISTORY AND YOUR PENDED CLAIM IS A 111
WHAT IS DENY DPC?
THE CLAIM HAS LINES PENDING AUTH FOR INJECTIONS AND THE AUTH ON FILE HAS NOTES WITH DOSAGE AND FREQUENCY SPECIFICATIONS.
WHAT IS CLAIM IS SDR?
YOU HAVE AN mEV EDIT AND THE PROVIDER SPECIALTIES ARE NOT THE SAME. FOR EXAMPLE ONE IS AN ENDOCRINOLOGIST AND THE OTHER IS A CARDIOLOGIST.
WHAT IS APPLY CE OVERRIDE AND NOTATE. DO NOT CONTINUE WITH THE EVALUATION AND MANAGEMENT SERVICES SOP.
YOUR CLAIM WAS RECIEVED A MONTH BEFORE THE PROCESSED HISTORY CLAIM BUT THEY HAVE DIFFERENCES BETWEEN THE TWO CLAIMS.
WHAT IS DENY THE CLAIM 627.
WHEN IKA AND HSS PRICER DO NOT MATCH
WHAT IS SEND FOR PRICING VERIFICATION?
YOU HAVE A PENDED 12X ON FILE, WHAT TOB NEEDS TO BE DENIED IN HISTORY?
WHAT IS A 111?
THE HOSPITAL BILLED FOR 9 DAYS, THE AUTH IS APPROVED FOR 7, THE CLAIM HAS BEEN IN THE SYSTEM FOR 53 DAYS.
WHAT IS SEND FOR PRICING OF APPROVED 7 DAYS?
YOU HAVE AN mEV EDIT AND BOTH CLAIMS ARE EXACTLY THE SAME.
WHAT IS DENY SECOND SUBMISSION AS DUPLICATE?
A CLAIM IS RECIEVED ON 1/26/2021 FOR A DATE OF SERVICE OF 4/5/2019 AND A HISTORY SEARCH SHOWS THE FIRST CLAIM DENIED LBI ON 6/5/2019. THE PROVIDER IS CONTRACTED WITH UNITED AND NO OTHER CLAIMS ARE ON FILE.
WHAT IS DENY CLAIM DTF?