Scheduled Outages: The HCAI system will be unavailable from 5:00 p.m. (EDT) September 29 to 8:00 a.m. (EDT) October 2
Scheduled Outages: The HCAI system will be unavailable from 5:00 p.m. (EDT) September 29 to 8:00 a.m. (EDT) October 2
Health Care Facility | Insurers | Related Initiatives  

Adjuster Reason Codes


When an adjuster wishes to decline a form or line item, he or she must select an appropriate ‘Reason Code’ from the list of available codes. It is important that this reason code accurately reflect the reason for their decision.

Reason codes provide valuable statistical information that informs your organization and the industry about the reasons why forms are declined.

Adjusters are encouraged to refrain from using the ‘Other’ code, when possible. This is because the freeform text next to this code cannot be collected or analyzed for privacy reasons.

If you have questions about which codes to use, please speak to a manager at your organization for direction.

For a complete list of reason codes, click here.