BCBS denial

97 -Payment is included in the allowance for another service/procedure.

Check whether the modifier is append for particular line item or take the w.o.

22 -Payment adjusted because this care may be covered by another payer per coordination of benefits.

We have to find the correct payer by verifying and resubmit the claims

CR 84 - Please submit history and physical,er report, progress notes, and discharge summary for review of this claim

We will send the Medical records along with claim for reprocess

204 - This service/equipment/drug is not covered under the patients current benefit plan

We will bill patient as service not covered under patient plan

197 -Payment adjusted for absence of Precertification /authorization

Check authorization in hospital website if available or call hospital for authorization details. If it is for office visit clarify with insurance by calling.

133 -The disposition of this claim/service is pending further review.

Claim denied for medical records and the same was submitted to insurance

51- These are non-covered services because this is a pre-existing condition

If the additional information available than we bill the claims along with medical records. Else we bill the patient.

56 -Medicare EOB is required to process this claim

Send the claim along with medicare eob to reprocess the claim

29 -The time limit for filing has expired.

Need to appeal the claim with proof of timely filing particularly clearing house proof.

MA122 -Missing/incomplete/invalid initial date actual treatment occurred.

Submit the claim along with first treatment date to reprocess the claim.
BCBS denial EOB
Medicare payment
BCBS claim submission address
Insurance claim denied
Denial claim example
Health insurance claim denials
Insurance denial appeal letter
Denial claim

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