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Send A letter - Ask for Confirmation of accident
REJTD & PTI – there is enough information to reject this claim.
FIPAY -there is enough information to pay this claim
Pay with reservation, no same body parts historical claim. Xray correlates to fall description
None
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Send A letter - Ask for Confirmation of accident
REJTD & PTI – there is enough information to reject this claim.
FIPAY -there is enough information to pay this claim
Pay with Reservation, no same body parts historical claim. Xray correlates to fall description
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Acc Emergency Treatment and Ambulance Ground/Water
Ambulance Ground/Water and Transportation 2
Ambulance Ground/Water and Acc Injury/Auto Accident
None
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Emergency Treatment, Follow-up and Xray
Emergency Treatment, Follow-up and Laceration
Emergency Treatment and Follow-up
Emergency Treatment and Concussion
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Emergency Treatment, Follow-up and Xray
Emergency Treatment, Follow-up, Laceration No Suture, Xray and PT
Emergency Treatment, Follow-up, Laceration, Xray and PT
Emergency Treatment, Follow-up, Laceration, Xray, PT, Apliance and Surgery
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Reject the claim
Route as possible fraudulent to Valarie Alston Nixon
Call the Provider to verify accident – if altered route as possible fraud to Valarie
Call the Provider to verify accident – if confirmed accident process as normal
Both C& D
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U088
U620
U622
U679
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S5RLH
O00XO
O6LXH
S6LSH
O20LO
O9LSH
O6RFH
S70UH
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Surgery Benefits - Accident Policies - CLA Outpatient Surgery Benefit - CLA
Date of Loss/Claim Event Date - CLA
Claims process was updated with information now reflects a priority 10 and below
Claims more than priority 10 are to be reviewed as Managing Pending Claim.
None of the above
A&D
B&C
A, B, C, D
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