Value |
Display Name |
Interpretation |
Comment |
Usage Note |
Modification Date |
Active |
C |
Signed CMS-1500 claim form on file, e.g., authorization for release of any medical or other information necessary to process this claim and assignment of benefits. |
|
|
|
Jul 13 2015 |
|
S |
Signed authorization for release of any medical or other information necessary to process this claim on file. |
|
|
|
Jul 13 2015 |
|
M |
Signed authorization for assignment of benefits on file. |
|
|
|
Jul 13 2015 |
|
P |
Signature generated by provider because the patient was not physically present for services. |
|
|
|
Jul 13 2015 |
|