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HEALTH FIRST COLORADOAPPENDIX Appendix R
Remittance Advice Messages
EOB
CodeDescription0000This claim/service is pending for program review.0007Information inadequate to establish medical necessity
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How to fill out 173 - prepaid denied
How to fill out 173 - prepaid denied
01
Contact the company or organization that issued the prepaid card.
02
Provide them with the details of the transaction that was denied, including the date, amount, and merchant.
03
Ask the company or organization for further instructions on how to resolve the issue.
Who needs 173 - prepaid denied?
01
Individuals who have experienced a denied transaction with a prepaid card.
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What is 173 - prepaid denied?
173 - prepaid denied refers to a specific form or report that indicates a prepaid expense or payment that has been denied for processing or reimbursement.
Who is required to file 173 - prepaid denied?
Individuals or organizations that have incurred prepaid expenses that have been denied should file the 173 - prepaid denied form.
How to fill out 173 - prepaid denied?
To fill out the 173 - prepaid denied form, include details such as the reason for denial, the amount involved, and any supporting documentation related to the prepaid expense.
What is the purpose of 173 - prepaid denied?
The purpose of 173 - prepaid denied is to formally document and report instances where prepaid expenses have not been accepted for reimbursement or processing.
What information must be reported on 173 - prepaid denied?
Information that must be reported includes the date of the transaction, involved parties, total amount of the prepaid expense, reason for denial, and any relevant reference numbers.
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