Billing — Rejections

Rejection triage by CARC/RARC codes and denial reason (flow Step 5). Resolve and resubmit are money-actions.


06f4953e-af7d-4af1-b6a3-bd7af6b0d19e	Texas Children's Health Plan MCO-TX	denied	CARC CO-B7 · RARC N767	Credentialing	Credentialing team CARC B7	97153, 97153
142f391e-61a9-415f-9be6-d2ff8c4cd916	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97153, 97153
2d3fc3c9-242e-4549-8d46-313b3a65be18	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153
3b993fad-7618-4fe3-ba6c-5da56218dffe	Molina-CA-SCA	denied	CARC CO-206, CO-B7 · RARC N257, N570	Credentialing; Invalid Provider Information	Credentialing team CARC B7	H0046, S5111
4abae4ef-55a3-4471-95c3-4497cdee93b8	Peach State Health Plan	denied	CARC CO-198 · RARC N54	Authorization Required	Auth team CARC 198	97153
585db0e8-3040-4dc3-b0e2-9582b963b102	UHC Community Plan	denied	CARC CO-45, CO-197	Authorization Required	Auth team CARC 197	97153
5cfd89ed-1f50-439c-9fb1-3c706d5b0142	Oscar Health-FL	denied	CARC CO-252 · RARC M127	Info Requested from Provider	—	97153, 97153
aa6a4e84-37b7-421b-9e24-96fa2b3bddbf	Health Plan of San Mateo	denied	CARC CO-96 · RARC N54	Non-Covered Benefit	VOB team CARC 96	97153
b9871e47-2116-43ac-a433-631e1427f2f3	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97156, 97155, 97153
cfbc99a2-d5cb-4080-bb68-b0dffd529201	Peach State Health Plan	rejected	—	UNKNOWN	—	97153, 97153
d3cdeb7c-1602-477c-87e5-21d973ddb1b3	Peach State Health Plan	rejected	—	UNKNOWN	—	97153, 97153
de470db4-b4df-4087-aaa6-8d9167e323ae	UHC/UBH/Optum-TX	denied	CARC CO-197, CO-45	Authorization Required	Auth team CARC 197	97155, 97153, 97153
de69ef53-ab03-4e1a-87cd-36cf69755093	Oscar Health-FL	denied	CARC CO-252 · RARC M127	Info Requested from Provider	—	97153, 97153
f15776e1-21a8-4a99-a331-b78a0bbf4bb5	Peach State Health Plan	rejected	—	UNKNOWN	—	97153
0316335f-225f-4b40-9b02-d0ec94f5a891	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97153, 97155, 97153
0e157fe8-643e-4360-8a7d-41f52af75d33	UHC Community Plan	denied	CARC CO-197, CO-45	Authorization Required	Auth team CARC 197	97153, 97153, 97153
2c5f9156-e603-443f-9fa3-6689efb95399	Amerigroup-TX	denied	CARC CO-22 · RARC MA04	Coordination of Benefits	VOB team CARC 22	97155
321fff94-5841-427b-a6cf-3bacccb8112d	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153, 97153
38f997dc-9d72-4e1f-be47-f6ce75d955ad	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97155, 97156
77ce4ea4-efa5-4cfd-a1ac-e0d910a14f09	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97156, 97153, 97153, 97155, 97153
7cea47c5-f6d6-4661-b72b-e0ace9817b80	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97153
dcdee2b0-fd99-4ae7-ac24-92c159c31317	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97153, 97153, 97155
e77ac288-7ccb-4390-9625-ab79d1ab1921	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97153, 97156, 97153
0f6c17a2-44c9-49bf-9193-bcf046dc3327	Partnership HealthPlan of California	denied	CARC CO-B11	Incorrect Payer	—	97151, 97151
6fb7cff3-4a00-41b4-92cc-0cf350092a95	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155

0 of 200 row(s) selected.