Complex Evaluation and Management procedures require history and physical or medical progress report to be submitted with the claim. Learn more about Ezoic here. Insufficient Documentation To Support The Request. This Claim HasBeen Manually Priced Using The Medicare Coinsurance, Deductible, And Psyche RedUction Amounts As Basis For Reimbursement. Payspan's Core Payment Network comes with a feature that allows payers to send members an electronic version of their Explanation of Benefits (eEOB). . Anesthesia and Moderate Sedation Services CPTs 00300, 00400, 00600, 01935-01936, 01991-01992, 99152-99153, 99156-99157, Pain Management Services CPTs 20552, 20553, 27096, 62273, 62320-62323, 64405, 64479, 64480, 64483, 64484, 64490-64495, 0228T, 0229T, 0230T, 0231T, G0260, Nerve Conduction Studies CPT 95907-95913, Needle electromyography (EMG)-CPT 95885, 95886. Please Disregard Additional Information Messages For This Claim. The Member Is School-age And Services Must Be Provided In The Public Schools. An Approved AODA Day Treatment Program Cannot Exceed A 6 Week Period. Check Your Current/previous Payment Reports forPayment. Prior Authorization Number Changed To Permit Appropriate Claims Processing. Please Supply NDC Code, Name, Strength & Metric Quantity. Header From Date Of Service(DOS) is required. Claim/adjustment Received Beyond The 455 Day Resubmission Deadline. The drug code has Family Planning restrictions. A Training Payment Has Already Been Issued To Your NF For This CNA. Header To Date Of Service(DOS) is invalid. Claim paid at program allowed rate. A Trading Partner Agreement/profile Form(s) Authorizing Electronic Claims Submission Is Required. Reimbursement For This Service Is Included In The Transportation Base Rate. New Coding Integrity Reimbursement Guidelines | Wellcare Claim Denied. Denied due to The Members First Name Is Missing Or Incorrect. Service(s) Approved By DHS Transportation Consultant. If A CNA Obtains his/her Certification After Theyve Been Hired By A NF, A NF Has A Year From Their Certification, Test, Date To Submit A Reimbursement Request To . The Member Is Also Involved In A Structured Living And/or Working Arrangement.A Reduction In Day Treatment Hours Is Indicated. Claim Submitted To Good Faith Without Proper Documentation. Pricing Adjustment/ Maximum Allowable Fee pricing used. Incidental modifier was added to the secondary procedure code. Suspend Claims With DOS On Or After 7/9/97. Only Healthcheck Modifiers Can Be Billed With Healthcheck Services.
