Transaction Grid - Adjustment

Description

The transaction grid lists related disputes, the original dispute amount and the new dispute amount.  Only used in partial denial resolution scenarios.

 

Content

Date

Description

Amount

Original Dispute Amount

New Dispute Amount

<Post Date>

<Descriptor>

<Amount>

<Dispute Amount>

<Amount Accepted>

 

Sample

Date

Description

Amount

Original Dispute Amount

New Dispute Amount

06/22/2024

WWW.CAREMARK.COM 888-892-7227 IL

$200.00

$200.00

$150.00

06/23/2024

AMAZON.COM AMZN.COM/BILL107

$197.00

$197.00

$100.00

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