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Reject Codes Definitions Test Claim Info Misc. Math
100
What is 70?
Product / Service Not Covered [Consignment].
100
What is Emdeon?
Alternate Insurance Finder website with Plan Search.
100
What is BIN #?
A processing number that identifies the insurance and we use to run a claim through insurance.
100
What is Over $4200 (per box)?
The copay dollar amount that is too high to apply a copay card, so we use Consignment instead.
100
What is $4500?
1 box - Reject 70 - Consignment - Drug Copay = ?
200
What is 608?
Step Therapy Required [Consignment].
200
What is Commercial Insurance?
Insurance through an employee and/or paid for by member with a monthly premium.
200
What is Person Code?
An identifier that helps define the specific patient on the account under the same ID #.
200
What is Consignment?
The manufacturer steps in to cover the cost of the medication when the insurance does not cover it, providing a free box (or 2) to the patient.
200
What is $9000?
2 boxes - Reject MR - Consignment - Drug Copay = ?
300
What is 88?
DUR Reject Error [Might be Refill Too Soon].
300
What is Substatus?
Different Queues in A1 as the Order makes it way through the process.
300
What is Pharmacy NPI?
The National Provider # that identifies the pharmacy.
300
What is Kaleo Cares?
When the patient cannot afford $360 cash cost or has a Medicaid plan, we offer them assistance with this.
300
What is $360?
Cash price cost of 1 box for patient with no insurance or commercial insurance.
400
What is 40?
Pharmacy Not Contracted.
400
What is CPT Code?
The Rejection Code we enter to inform the system why we choose Consignment.
400
What is Copay: N/A?
When the claim is not connecting with insurance, due to computer / processing issues, and we must try again later.
400
What is 0.15mg?
The FDA-approved dosage for a patient that is below the weight of 66 lbs.
400
What is $9000?
4 boxes - Reject 608 - Consignment - Drug Copay = ?
500
What is N1?
Unknown / Unable to Find Patient.
500
What is Asembia1?
The internal system used to process orders, run test claims, call patients, and schedule deliveries.
500
What is Dispense as Written?
DAW stands for this.
500
What is Kindly Hang up and Call again?
When the insurance refuses to provide information to us because we are not calling directly from the pharmacy, the next step is this.
500
What is 2?
1+1




Asembia1 BVs

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