Medicaid denial

0660 Calculated payment equals zero. Other insurance paid more than Medicaid Allowable.

Adjusted the claim (Medicaid write off)

2091 Recipient services covered by HMO plan

Claim would be filed to Medicaid HMO's

0142 Claim exceeds 12 month filing limit

Claim appealed with Clearing house acceptance report

0312 Referring provider required for this procedure in field 17A/19.

Issue raised to calling team regarding the PCP info after that updated the info with dummy#000000100 and refiled the claim.

2346 Referring provider number not on file

Dummy#000000100 updated in 17A and refiled the claim.

4888 NDC Missing/Invalid

NDC# updated in claim note and refiled the claim

0721 Recipient ineligible for date of service

After Medicaid eligibility, if the patient have other active insurance claim filed to other carrier. If patient have no other coverage bill to patient.

0720 Medicare coverage is present

After Medicare verification claim filed to Medicare

4257 Invalid procedure code modifier

Removed modifier and refiled the claim.

4801 These services cannot be billed on this claim form or the provider type listed for this provider number cannot file this type of claim.

Normally G codes denied for this reason. After Medicare payment claim has been adjusted.

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