What reason is given in the RA for the rejected procedure? What is the description of the procedure? 2. Refer back to the encounter form for Lakshmi Prasad in Claim Case Study 15.4 (page 491). Does the encounter form contain the same procedure code that is listed in the RA? 3. Refer next to Lakshmi Prasads patient information form. Confirm that Lakshmi is an established patient. Also verify the reason for the visit as described on the patient information form. 4. Next, check the patient information form for Lakshmis date of birth. Based on her age on the patient information form, what correction should be made to the encounter form and claim information? 5. You can actually use the CMS-1500 form below to complete this secondary claim. During the electronic submission of Lakshmi Prasad's 10/06/2018 claim to the insurance company, the office visit procedure code was changed. The claim must be re-submitted with the appropriate procedure code. Reminder, the Patient NO. is PRASALA0. Prepare the claim for this case by completing the appropriate fields in the CMS-1500 form provided. Accuracy is important. Please note that tabbing through the form works inconsistently; it is recommended that you click in each field for which you want to enter information. For the purposes of Connect, all dates you should be entered in 8-digit format (XX in MM field; XX in DD field; XXXX in YY field) except for Section 24, where the dates should be entered in 6-digit format (XX in MM field; XX in DD field; XX in YY field). Be sure to use the BILLING PROVIDERS phone number in Item Number 33.