Mismatch involving the submitted purchasing/referring supplier name as well as purchasing/referring supplier identify saved within our information.

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Service provider need to acknowledge insurance payment as payment in entire any time a third party payer agreement specifies whole reimbursement.

Medical provider not authorized/Qualified to provide cure to injured employees With this jurisdiction.

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Notify: You might not attraction this final decision but can resubmit this claim/support with corrected information and facts if warranted.

Process code or technique price depend cannot be established, or wasn't on file, with the date of service/service provider.

No attractiveness suitable other than duplicate assert/company issue. This services was included in a assert that has been previously billed and adjudicated.

The client was not residing in a lengthy-expression care facility during all or part of x12 the assistance dates billed.

This drug/support/offer is not really included in the payment agenda or contracted/legislated rate arrangement.

The most allowable payment for this company/course of action was compensated by the first insurance. No further payment due.