OA Rejections
CMS - Custody Medical Services AMM03 - Box 11c (SBR04) (RC124)
Rejection
Missing Plan Name: AMM03 Requires EMSF, CMS, CAR, TPB, or CTU indicator in Box 11c (SBR04) (RC124)
What happened
Box 11c is missing one of the above indicators.
Resolution
Add one of the indicators in box 11c and update the claim.