The 5 most common explanatory codes that our users get from a rejection of a claim are as follows:
Processed according to the description of the fee item, or the note relating to the fee item, in the Payment Schedule.
This is a duplicate claim. An identical claim is being processed.
This claim will be processed on a future remittance statement. Please do not re-bill.
One 00114 is paid every two weeks for care provided in a long-term care institution (eg. nursing home, intermediate care facility) unless supported by an explanation.
Fee items 01151 and 13052 are not applicable when performed in conjunction with other anesthetic services.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.