| Name | Value |
|---|---|
| NAME | FB UNAUTHORIZED EDIT |
| DESCRIPTION | If dispositioned claim has been reopened, this template is used to keep the authorization information in synch with the unauthorized claim |
| DATE CREATED | 2001-07-19 15:10:00 |
| FILE | FEE BASIS PATIENT |
| DATE LAST USED | 2001-07-19 00:00:00 |