![]() Multiple Prescriptions For Same Drug/ Same Fill Date, Not Allowed. Pediatric Community Care is limited to 12 hours per DOS.ĭrug Dispensed Under Another Prescription Number. Service Paid At The Maximum Amount Allowed By ForwardHealth ReimbursementPolicies.ĭollar Amount Of Claim Was Adjusted To Correct Mathematical Error.Ī discrepancy exists between the Other Coverage Indicator and the Other Paid Amount. Please Attach Copy Of Medicare Remittance. Medicare Part A Services Must Be Resubmitted. Member is enrolled in Medicare Part A and/or Part B on the on the Dispense Dateof Service. ![]() ![]() The Number Of Weeks Has Been Reduced Consistent With Goals And Progress Documented. Information inadequate to establish medical necessity of procedure performed.Please resubmit with additional supporting documentation. Number Is Missing Or IncorrectįorwardHealth Number On Claim Does Not Match ForwardHealth Number On Prior Authorization Request.ĭME rental beyond the initial 30 day period is not payable without prior authorization.Ĭharges Paid At Reduced Rate Based Upon Your Usual And Customary Pricing Profile.Īmount Paid Reduced By Amount Of Other Insurance Payment. This claim/service is pending for program review. On the last page of the Remittance Advice. Providers will find a list of all EOB codes used with the corresponding description #Geico claim status codeAn Explanation of Benefits (EOB) code corresponds to a printed message about the status or action taken on a claim. ![]()
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