Coverage Status Codes in Emerge:
When viewing the Coverage tab in Emerge, please take note of the coverage status.
Use this table as a reference tool.
ACT |
Active |
CAN |
Canceled |
DEC |
Deceased |
IAG |
Aged Out |
INE |
Ineligible. Must be eligible for TRICARE or CHAMPVA to enroll. |
RAT |
Rate Increase. Emerge ties rate tables to coverages, so when the rate table changes, the coverage line must also change. |
TRA |
Lapsed for Non-Payment |
TRM |
Terminated |
Claim Status Codes in Emerge:
When viewing claims in Emerge, please take note of the claim status. Use this table as a reference tool. The most common claim status codes in Emerge highlighted in yellow.
C |
Controlled |
E |
Eligibility |
F |
Finalized |
I |
In-Process |
J |
Re-Adjudicated |
N |
Re-Assigned |
P |
Processed |
R |
Rejected |
S |
Suspended |
U |
Unsuspended |
X |
Voided |
When providing Claim Status there is a format that we use:
1. We received your claim on 02/25/2019
2. The status of your claim is Final
3. We processed your claim on 03/02/2019
Use your EOB Remark code job aid and supply the outcome of the claim.
