Claim Adjustment Reason Codes - Palmetto GBA

ReasonCodesN499N500N501N502N503N504N505N506N507N508DescriptionMissing Medical Legal Report.Start: 07/01/2008Incomplete/invalid Medical Legal Report.Start: 07/01/2008Missing Vocational Report.Start: 07/01/2008Incomplete/invalid Vocational Report.Start: 07/01/2008Missing Work Status Report.Start: 07/01/2008Incomplete/invalid Work Status Report.Start: 07/01/2008Alert: This response includes only services that could be estimated inreal time. No estimate will be provided for the services that could not beestimated in real time.Start: 11/01/2008Alert: This is an estimate of the member's liability based on theinformation available at the time the estimate was processed. Actualcoverage and member liability amounts will be determined when theclaim is processed. This is not a pre-authorization or a guarantee ofpayment.Start: 11/01/2008Plan distance requirements have not been met.Start: 11/01/2008Alert: This real time claim adjudication response represents the memberresponsibility to the provider for services reported. The member willreceive an Explanation of Benefits electronically or in the mail. Contactthe insurer if there are any questions.Start: 11/01/200883