Insurance coverage problems have been encountered. Additional explanation information to be supplied.

Electronic form with supporting or additional information to follow.

Fax with supporting or additional information to follow.

The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.

Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.

Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal.

The medical service and/or product was provided to a patient that has coverage in another jurisdiction.

The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.

Paper documentation (or other physical format) with supporting or additional information to follow.

Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission.

Allows provider to explain lateness of invoice to a subsequent payor.

Rules of practice do not require a physician's referral for the provider to perform a billable service.

The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate.

The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items.

The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.