Remittance Advice Expenditure Reason Codes
General Provider
Reason Code | Expenditure Reason | Description |
---|---|---|
0070 | Capitation | Capitation Payment |
0247 | EHR Payment | Electronic Health Record Payment |
0292 | FQHC Outstation | Federally Qualified Health Center Outstationing Payment |
0340 | GME - Inpatient | Graduate Medical Education payment for inpatient managed care utilization |
0345 | GME-Outpatient | Graduate Medical Education payment for outpatient managed care utilization |
0350 | OutptCostSettlm | Outpatient Cost Settlement Payment |
0390 | Incentive Exp | Incentive Expenditure |
0545 | No Payr Inf-Ref | No Payor Information - Refund to provider for paper check received via mail. This may be due to one of the following circumstances: The claim was already denied, the claim was already adjusted, or the check received could not be matched to a claim. Contact the Provider Services Call Center for assistance and further details on claims status. |
0650 | Other | Other (Contact the Provider Services Call Center for assistance and further details on claims status.) |
0670 | Overpayment | Overpayment |
0747 | RHC Rate Recon | Rural Health Center Rate Reconciliation Payment |
Managed Care Organization (MCO)-Specific
Audience | Reason Code | Expenditure Reason | Description |
---|---|---|---|
Colorado Access only | 0430 | KPI Incentive | KPI Incentive Payment |
DentaQuest only | 0162 | Dental ASO-XIX | Dental Administrative Service Organization – Medicaid Payment |
Denver Health HMO only | 0152 | DHH NEWBRN DLIV | Denver Health Medical Plan Newborn Delivery Payment |
Denver Health HMO only | 0195 | Hep C Drug DHHA | Hep C Drug Payment – Denver Health Medical Plan |
HMOs only | 0200 | HIPF Recon | Health Insurance Provider Fee – Capitation Adjustment for Provider Tax Liability |
MCOs only | 0080 | Casualty | Casualty Payment |
Rocky Mountain Health Plan HMO only | 0196 | Hep C Drug RMHP | Hep C Drug Payment – Rocky Mountain |