UG-BDRG-001 Issue 2-April, 2005

The Billing Adjustment Request (BAR) Form is BellSouth's preferred submission form when disputing a claim. The BAR is divided into five sections. The CLEC disputing the claim is responsible for completing the first two sections (the Carrier Dispute Section and the Disputing Carrier Contact Section), and the BellSouth representative processing the dispute is responsible for completing the last three sections (the BellSouth Dispute Receipt Acknowledgement Section, the Dispute Rejection Section and the Billing Adjustment Response Section). The representative processing the dispute is responsible for verifying that the BAR is populating correctly. The following are common examples where BellSouth denied a claim during the initial review of the BAR:

• Insufficient information on the dispute claim form
• Inclusion of inaccurate information on the dispute claim form
• Submitting a duplicate dispute claim form
• Submitting a duplicate claim form to the wrong center

When filling out the BAR, follow the step-by-step instructions found within each of the sections below.