116 (137)    ADJUSTMENT REASON (161.91)

Name Value
CODE 116
STATUS EFFECTIVE DATE
  • 2003-06-01 00:00:00
    STATUS:   ACTIVE
    FEE USE:   APPLICABLE
DESCRIPTION EFFECTIVE DATE
  • DESCRIPTION:   
    The advance indemnification notice signed by the patient did not comply 
with requirements.
  • DESCRIPTION:   
    The advance indemnification notice signed by the patient did not comply with requirements.
SUSPENSION DESCRIPTION 
The advance indemnification notice signed by the patient did not comply with requirements.
CORE SCENARIO Incorrect Documentation
ADJUSTMENT GROUP