| A | B |
|---|
| CO.24 Covered Under Manage Care Program | Patient has Medicare Replacement Plan |
| CAS:252 An Attachment/Other Documentation Is Required to Adjudicate This Claim | Insurance needs Medical Records in order to process the claim |
| CAS:29 Time Limit for Filing has Expired | Timely Filing |
| CAS:45 Charge Exceeds Fee Schedule/Maximum Allowable or Contracted Fee Arrangement | Contractual Adjustment/This is based off the contract with the insurance |
| CAS:3 Co-payment Amount | Patient's Copay Responsibility |
| CAS:242 Services Not Provided by Network/Primary Care Providers | Not Contracted with Insurance |
| CAS:97 and M15 The Benefit For This Service Is Included In The Payment/Allowance for Another Service/Procedure That Has Already Been Adjudicated | There Are Codes That Bundle on Same Date of Service |
| CAS:4 The Procedure Code is Inconsistent With The Modifier Used Or A Required Modifier Is Missing | Modifier is Incorrect or Modifier is Missing |
| Deductible | The Amount the Patient Pays Before the Insurance Will Start to Pay on Healthcare Services |
| Out Of Pocket (OOP) | The Most You Have To Pay for Covered Services In a Plan Year |
| Coinsurance | The Percentage of Costs of a Covered Health Care Service You Pay After You've Paid Your Deductible |
| CAS:234 This Procedure Is Not Paid Separately | This Code Needs Another Code to Be Billed with the Services Rendered |
| CAS:18: Exact Duplicate Claim | Duplicate Claim |
| Optumcare | UHC Medicare Advantage |
| Wellcare/Allwell | Arizona Complete Medicare Advantage |
| Banner University Advantage Care | Banner University Medicare Replacement |
| Banner University Family Care | Banner University AHCCCS plan |
| Medicare Replacement Plan | Private Health Insurance Plan that can be used to supplement original Medicare |
| ICN | Internal Claim/Control Number (Insurance Number they attach to a processed claim) |
