| A | B |
|---|
| 01 | BEN: DEFAULT BEN LEVEL |
| 04 | CLAM: AUTHORIZATION NOT FOUND |
| 05 | BEN: DEFAULT BEN CAT |
| 06 | CLM: MORE THAN ONE AUTH FOUND |
| 07 | CLM: DEFAULT AUTHORIZATION |
| 08 | RMB: NEGOTIATED RATE REQUIRED |
| 09 | COB: NO COB OIC ALLOWED/PAID AMTS |
| 10 | CLM: OCR CLAIM WITH COB INFORMATION |
| 11 | COB: OIC INFO ON CLAIM WITH NO COB ON FILE |
| 13 | COB: POSIBLE COB INFO ON CLAIM |
| 14 | COB: MANUAL PEND TO COB DEPT |
| 15 | CLM: COB ENTERED VIA PRELOG |
| 16 | CLM: COB CARRIER DOES NOT MATCH MBR COB |
| 17 | PRV: MANUAL PEND TO PROVIDER DEPT |
| 18 | PRC: MANUAL PEND TO PRICING DEPT |
| 19 | BEN: MANUAL PEND TO BENEFIT DEPT |
| 20 | PSY: MANUAL PEND TO PSYCH CONSULT DEPT |
| 21 | RMB: MANUAL PEND TO REIMBURSEMENT DEPT |
| 22 | MBR: MANUAL PEND TO MEMBERSHIP DEPT |
| 23 | ADJ: MANUAL PEND TO ADJUSTMENT DEPT |
| 24 | CLM: MANUAL PEND TO SUPERVISOR |
| 25 | CLM: MANUAL PEND TO CLAIMS/AUTH ISSUES |
| 26 | CLM: RETURN TO CLAIMS DEPT |
| 27 | CLM: POSSIBLE DUPLICATE |
| 28 | CLM: HOLD FOR REVIEW OF CLOSED AUTHORIZATION |
| 30 | PRV: PROVIDER NOT ON FILE |
| 31 | PRV: DEFAULT PROVIDER PEND |
| 33 | CLM: OVER TIMELY FILING - VERIFY REMIT DATE |
| 34 | ADJ: CORRECTED CLAIM, VERIFY CLAIM CRITERIA |
| 35 | PRC: DEFAULT MODIFIER |
| 36 | CLM: SPECIFIC QUANTITY AND GLOBAL AUTHS |
| 37 | CLM: LANGUAGE INTERPRETER |
| 38 | CLM: HOLD FOR PWK EB |
| 39 | MBR: MEMBER NOT ON FILE |
| 40 | PRV: PAY vc0567 ONLY AS MEDICARE SECONDARY |
| 41 | CBH: MANUAL PEND TO COMMUNITY CARE FOR P |
| 42 | PRV: MAUAL PEND FROM COMMUNITY CARE TO |
| 44 | CLM: CLAIMS HIGH DOLLAR REVIEW |
| 45 | CLM: PAY AS PRIMARY |
| 47 | CLM: OVER TIMELY FILING - REFER TO DISCHARGE DATE |
| 48 | CLM: MANUAL PEND CONFIG DEPT TO CLAIMS |
| 52 | CLM: PRIOR TO 10/01/2007 |
| 57 | CLM: EXCEPTION - OVERRIDE TIMELY FILING |
| 58 | PRV: CINVAL RENDERING PROVIDER HOLD |
| 67 | CLM: ADMIT DATE IS MISSING OR INVALID |
| 68 | CLM: DISCHARGE STATUS IS MISSING OR INVALID |
| 70 | CCBH: AUTISM HOLD |
| 76 | CCBH: SIU DENY HOLD |
