Submit Claim with Remarks

ConnectCenter requires both the qualifier and the associated values in box 80. The field containing "QC" must contain one of the following values and the associated detailed information should go in to "remark" section.

ALG Allergies
DCP Goals, Rehabilitation Potential, or Discharge Plans
DGN Diagnosis Description
DME Durable Medical Equipment (DME) and Supplies
MED Medications
NTR Nutritional Requirements
ODT Orders for Disciplines and Treatments
RHB Functional Limitations, Reason Homebound, or Both
RLH Reasons Patient Leaves Home
RNH Times and Reasons Patient Not at Home
SET Unusual Home, Social Environment, or Both
SFM Safety Measures
SPT Supplementary Plan of Treatment
UPI Updated Information
ADD Additional Information