Resubmit a Claim When you need to resubmit a claim, file an appeal, or send a corrected claim, use the Billing History in the patient’s chart to add claim resubmission information to the encounter and queue up a new claim. Step 1: Select the Encounter In the patient’s Billing History,...
MEDICAID RESUBMISSION CODE ORIGINAL REF. NO. 1. 3. 23. PRIOR AUTHORIZATION NUMBER 2. 4. 24. A B C D E F G H I J K N DATE(S) OF SERVICE Place Type PROCEDURES, SERVICES, OR SUPPLIES DAYS EPSDT RESERVED FOR O From To of of (Explain Unusual Circumstances) DIAGNOSIS OR Family I ...
accordance with the provisions of California Code of Regulations (CCR), Title 22 and policies established by the Department of Health Care Services. claim sub 7 1– Claim Submission and Timeliness Overview December 2009 Resubmission Turnaround A Resubmission Turnaround Document (RTD) is sent to pro...
resubmission OPTIONAL No entry required. 23 Prior authorization number SITUATIONAL REQUIRED if there is a prior authorization, enter the prior authorization number. Obtain the prior authorization number from the prior authorization form. 24A. Date(s) of ...