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The list of Auth Payer Pending Reason category IDs for the Auth Bundle's payer decision information. Only relevant when the payer decision is pending. |
May contain organization-specific values: No |
Category Entries: |
Clinicals Requested |
Coverage Verification Needed |
System Automatically Pend |
Potential Duplicate Referral |
Referral Network Review |
Does Not Pass Benefit Check |
Needs Medical Review |
Payer Response Needs Review |
Created from DMS |
Needs Peer to Peer |
Clinicals Sent |
Authorization Initiated |
Clinicals Received |
Additional Visits Needed |
Medical Director Denied |
Concurrent Review |
Not Enough Information |
Covered by Pharmacy Benefit |
Request Needs Review |
Waiting on Payer |