![]() The procedure code is inconsistent with the provider type/specialty (taxonomy). Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present. The procedure/revenue code is inconsistent with the patient's age. ![]() The procedure code/type of bill is inconsistent with the place of service. The procedure code is inconsistent with the modifier used. The payer does not always use the mandated additional RARC code, which I am dealing with the Simplification Act Mandate per payer to fix. ![]() The procedure/revenue code is inconsistent with the patient's sex. Should be changed to be accurate which would be: The procedure/revenue code is inconsistent with the patient's gender. Claims will be processed under a new claim number.ĭue to Federal/State Mandate Continuity of Care (CoC), this claim has been processed at the In-Network level of benefit Our records indicate injured party is reserving/directing payment of PIP/MPC benefits.Ĭlaim closed due to changes in submitted data. No Surprises Act (NSA) Qualifying Payment Amount (QPA) Claim has been forwarded to the patient's medical delegated health plan for further consideration. Claim received by the medical plan, but benefits not available under this plan.
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