Define a new CPCDS data element,  Payment Denial Member Explanation

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    • Type: Change Request
    • Resolution: Persuasive
    • Priority: Highest
    • US CARIN Blue Button (FHIR)
    • 0.1 [deprecated]
    • Financial Mgmt
    • (NA)
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      A new CPCDS data element, Line Payment Denial Member Explanation, will be defined.  It will be mapped to all four EOB profiles.  

      The  data element will be mapped to the FHIR data element EOB.processNote and with a rule to reference item.noteNumber.

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      A new CPCDS data element, Line Payment Denial Member Explanation, will be defined.  It will be mapped to all four EOB profiles.   The  data element will be mapped to the FHIR data element EOB.processNote and with a rule to reference item.noteNumber.
    • Mark Roberts/Bob Dieterle: 14-0-2
    • Enhancement
    • Compatible, substantive

      Define a new CPCDS data element, Member Payment Denial Explanation

      This is a line level payer specific reason conveying a denial explanation to a member, typically goes on the EOB when the payment is denied or disallowed.  This is not the same as the CARC / RARC codes payers provide to providers.  

            Assignee:
            Unassigned
            Reporter:
            Patricia Taylor
            Watchers:
            1 Start watching this issue

              Created:
              Updated:
              Resolved: