N139 (337)    REMITTANCE REMARK (161.93)

Name Value
CODE N139
STATUS EFFECTIVE DATE
  • 2003-06-01 00:00:00
    STATUS:   ACTIVE
    FEE USE:   NOT APPLICABLE
DESCRIPTION EFFECTIVE DATE
  • DESCRIPTION:   
    Alert: Under the Code of Federal Regulations, Chapter 32, Section 199.13 
    a non-participating provider is not an appropriate appealing party. 
    Therefore, if you disagree with the Dental Advisor's opinion, you may 
    appeal the determination if appointed in writing, by the beneficiary, to 
    act as his/her representative. Should you be appointed as a 
    representative, submit a copy of this letter, a signed statement 
    explaining the matter in which you disagree, and any radiographs and 
    relevant information to the subscriber's Dental insurance carrier within 
    90 days from the date of this letter.