Deferrals and Rejects

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Across
  1. 3. For U6FIL, the ___ claim number can be found on the RMIM Summary Claim List or in the Add Data tab
  2. 7. D9LES is the deferral for when an adjustment is paying ___ than the original claim
  3. 8. U2000 is the reject where patient's plan does not cover ____ charges above the purchase price
  4. 9. For the D9AIC deferral, be sure to check the ____ ____ code
  5. 10. RPITE is the reject where patients plan does not cover comfort, convenience, or ____ items
  6. 11. UCOLR, for this reject the colonoscopy should be filed as ____
  7. 12. R9031 is the reject for no ____ on the SF
  8. 14. U0502 is the reject where a claim was filed with the incorrect ID number/Alpha prefix
  9. 15. R6VER is the reject where a ____ is not showing active under a policy
  10. 16. RP005 is the reject where patient's plan does not cover ___ options on lensed or DME
  11. 17. Blue Card ____ ____ Manual
  12. 18. RSUPL is the reject where patient's plan only covers surgical procedures rendered by Surgery ___ Providers
  13. 19. R6290 is the reject where the _____ provider shows located in SC in PIMI
  14. 20. USTUF, the service(s) filed are included in the ___ allowance
Down
  1. 1. Resource to locate Work Instructions
  2. 2. R1051 is the reject for Provider ____ Mismatch
  3. 3. D8SUB is the deferral for Pay to Subscriber Claims
  4. 4. RNOGN is the reject for services not covered for providers outside of the member’s ___ network
  5. 5. D9555 is the deferral for the Deductible being _____ than the allowed amount
  6. 6. UCMRT, the claim should be filed to ____ Blue Cross
  7. 13. A claim for a transplant donor should be filed as that of the ____
  8. 16. The ___ Tracker is the resource used to ask questions on how to handle a specific reject