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2013 4.9 Satisfied (440 Votes)
2010 4.3 Satisfied (58 Votes)
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A: You will receive this reason code when more than one claim has been submitted for the same item or service(s) provided to the same beneficiary on the same date(s) of service.
Claim adjustment group code used to categorize a payment adjustment for a claim or claim line. This field is currently only populated for Direct Contracting (DC), Comprehensive Kidney Care Contracting (CKCC) and Kidney Care First (KCF) model claims.
Claims Adjustment group is an Independent claims adjusting service handling Multi-Line Claims Services, Catastrophe Claims Management, Appraisals and Mediation.
OA-23. This code indicates the impact of prior payers adjudication, including payments and/or adjustments. If you receive this code, you dont need to take any action, as the amount listed is equivalent to that allowed by the primary payer.
OA-23. This code indicates the impact of prior payers adjudication, including payments and/or adjustments. If you receive this code, you dont need to take any action, as the amount listed is equivalent to that allowed by the primary payer.
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OA = Other Adjustments. PI = Payer Initiated Reductions. PR = Patient Responsibility.
(401) 274-4848 .BCBSRI.COM A new claim with correct and complete information must be submitted in order for a denied claim to be reconsidered. The Claims Adjustment Request Form, to be completed and submitted with a corrected claim, is available on the provider section of BCBSRI.com.
OA (Other Adjustments) is used when CO (Contractual Obligation) nor PR (Patient Responsibility apply. This can be used when the claim is paid in full and there is no contractual obligation or patient responsibility on the claim.

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