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New reject reason code for Part A claims returned to a provider more than three times
Last Modified: 7/6/2022
Location: FL, PR, USVI
Business: Part A
Claims are returned to provider (RTP) when information needed to adjudicate them is missing or incomplete. First Coast will reject claims returned to a provider more than three times with reason code 70RTP.
Our goal is to reduce a high number of cycling and unresolved RTP claims with this reason code.
Avoid new reject code 70RTP
It is very important that providers check their RTP file regularly for returned claims. In most situations, we receive the same claim back without the necessary updates or changes per the adjudicator's remarks or reason code instructions. This can happen for different reasons:
• Overlooking or ignoring the remarks or reason code(s)
• Vendor software that systematically returns the claims to First Coast without giving billing personnel the opportunity to review remarks and add the requested information, or
• Remarks or reason codes are misinterpreted
Please make sure to share this important change with your billing representatives and make all necessary changes to your RTP claim to prevent unnecessary rejections.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
