This field indicates whether Railroad Board (RRB) beneficiary claim should be excluded from Prior Authorization processing
This field informs the SSMs and CWF if the RRB beneficiary claim should either be included or excluded from Prior Authorization (PA) processing. Ex: If the field is valued “Y”, and it is RRB beneficiary claim, it will be excluded from PA processing.
This field was new in April 2019.
|Y||Yes (exclude RRB beneficiary from PA)|
|Null/missing||Subject RRB beneficiary services to prior authorization|