chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

MIC MEDICAID INTGRTY 0 ALLW 0
H/L MCAID TIMELY -39 FILING -39
H/L MCAID REG ERROR 0 0
H/L MEDICAID OTHER0 0
H/L MEDICAID NON CREDENTI 0 0
H/L MDCD CLINICAL ERROR 0 0
H/L MEDICAID NO AUTH -64 -64
H/L MEDICAID MEDICAL 0 NEC 0
H/L MEDICAID DAYS DENIED 0 0
H/L MCAID AUTH/SVC 0 MISMAT 0
H/L MEDICAID NON COVERED 0 0
H/L MCAID ADMINISTRATION 0 0
H/L MCAID PATIENT/MEMBER 0 0
H/L MIC MEDICAID INTGTY 0 0
MAINE MEDICAID ALLOWANCE -1 -1
BLUE CROSS ANTHEM -2027ALLOW-2027
BLUE CROSS/BC ALLOW -14 -14
ALLOW PROF FEE BLUE -11 CROSS -11
PSYCH BC ANTHEM -122 BEH ALLOW -122
PSYCH BC MAGELLAN 0ALLOW
0
PSY BC UNTD BEHAV 0ALLOW
0
PSYCH BC VAL BEHAV 0ALLOW
0
PSYCH BC VAL OPT ALLOW 0 0
PSY BC MGD HLTH NTWK 0 ALLW 0
TCORS WC ALLOWANCE 0 0
H/L B/C TIMELY FILING0 0
H/L B/C REG ERROR 0 0
H/L BLUE CROSS OTHER 0 0
H/L BLUE CROSS NON 0CRED
0
H/L BL CR CLINICAL ERROR 0 0
H/L B/C NO AUTH ON -6FILE
-6
H/L BCBS MEDICAL NECESSIT 0 0
H/L BLUE CROSS DAYS -1 DENY -1
H/L B/C AUTH/SVC MISMATCH 0 0
H/L B/C NON COVERED 0 SVC 0
H/L B/C ADMINISTRATION 0 0
H/L B/C PATIENT/MEMBER 0 0
H/L BC PRO FEE TIMELY -1 FLE -1
H/L BC PRO FEE NO AUTH 0 0
H/L BC PRO FEE CREDENTIAL 0 0
H/L BC PRO FEE OTHER 0 0
PSY CIGNA BEHAV HLTH -19 ALLW-19
AIM CIGNA ALLOW 0 0
AMALGAMATED LIFE 0ALLOW
0
CIGNA ALLOWANCE -750 -750
CIGNA/CIGNA ALLOW0 0
CONN GENERAL ALLOW 0 0