Reversed Claim definition
Reversed Claim means a Claim that initially is Paid, but for which a subsequent Claim with the same participating pharmacy, mail service pharmacy, and/or specialty pharmacy, covered individual, prescription number, and NDC was submitted for reversal of payment.
Reversed Claim means a Claim that initially is paid but a subsequent Claim with the same Pharmacy, Covered Individual, prescription number, and NDC was submitted for reversal of payment.
Reversed Claim means a previously Paid Claim, that was submitted by the pharmacy to the PBM in a Billing Transaction requesting a reversal of the previously paid Transaction and processed as an accepted Reversed claim, as indicated in the PBM's response Transmission.