Billing — Rejections

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


cfd5aed9-1c54-478a-9484-5def817a0791	Tricare East - FL	denied	CARC CO-B7 · RARC N95	Credentialing	Credentialing team CARC B7	97151
d56d9341-3c2c-4198-8171-bd387bdb9852	Cigna-TX	denied	CARC CO-119, OA-94, CO-45, PI-97 · RARC N130, N362	Max Benefit Reached	VOB team CARC 119	97151, 97151
daf7ba56-8fa3-48e9-8592-f759db198edb	Molina-CA-SCA	denied	CARC CO-206 · RARC N257	Invalid Provider Information	—	H0046
db3fd022-7be1-4423-a240-a12e73c97220	UHC/UBH/Optum-FL	denied	CARC CO-96, CO-45 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97153
dce53c8d-25b6-4819-bd70-45f81e1fbcc7	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
e53c153e-6036-4c3a-a618-8e52bb511008	Aetna-NJ	denied	CARC OA-18, CO-45	Duplicate Claim	Billing — combine units CARC 18	97153, 97153, 97155, 97153
e5708779-0e26-4b80-b703-e732bf71155f	Partnership HealthPlan of California	denied	CARC CO-B11	Incorrect Payer	—	97151, 97151, 97151
e8ba2cfa-659f-48d8-940d-b2306b6e4034	UHC/UBH/Optum-FL	denied	CARC CO-197	UNKNOWN; Authorization Required	Auth team CARC 197	97155, 97151, 97155
f38844fe-3ebc-469b-b2e5-d6784cfb6aa9	Superior Health Plan-TX	denied	CARC CO-198 · RARC N54	Authorization Required	Auth team CARC 198	97156
f3bcdf54-a20e-4bd5-b4b9-f97a97fe06c3	UHC/UBH/Optum-FL	denied	CARC CO-96, CO-45 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97153, 97153
f52a19a0-880a-436f-a1e0-c68ee262818d	Cigna-TX	denied	CARC CO-119, OA-94, CO-45, PI-97 · RARC N130, N362	Max Benefit Reached	VOB team CARC 119	97151
fe666022-e0f8-4516-a48b-8541794588f2	Superior Health Plan-TX	denied	CARC CO-22 · RARC N4	Coordination of Benefits	VOB team CARC 22	97155
014339c1-dc21-4dd3-996d-5c7148960483	BCBS OF TX	denied	CARC CO-B11, CO-45 · RARC M115, N418	UNKNOWN; No Effective Contract	—	97155, 97156
09842cc8-341c-4feb-8edf-45603a80ac7e	UHC Community Plan	denied	CARC CO-96, CO-45 · RARC N188	Full Contractual Adjustment; Non-Covered Benefit	VOB team CARC 96	97153, 97153, 97153
0ac994c4-27a1-4f26-9fcb-e072df2e4ffc	BCBS OF TX	denied	CARC CO-B11, PR-B7 · RARC N665, M115, N418	UNKNOWN; Credentialing	Credentialing team CARC B7	97155
0c0b46b5-9d5d-4c61-a74b-b45889a0c9e3	Texas Children's Health Plan MCO-TX	denied	CARC CO-B7 · RARC N767	Credentialing	Credentialing team CARC B7	97156
1335080c-a4bd-431a-9226-5bbdbfad9546	Carelon Medi-Cal	denied	CARC CO-22 · RARC N479	Coordination of Benefits	VOB team CARC 22	H2019
1739f63e-ce61-4eed-8a11-f60e63c933b6	Carelon Medi-Cal	denied	CARC CO-22 · RARC N479	Coordination of Benefits	VOB team CARC 22	H2012
1ccb528d-f7a2-431c-8080-6edd99c86657	UHC/UBH/Optum-FL	denied	CARC CO-96, CO-45 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97153
1d365a4f-d868-4231-aa2a-f1f647917df1	Superior Health Plan-TX	denied	CARC CO-119, CO-45 · RARC N362	Full Contractual Adjustment; Max Benefit Reached	VOB team CARC 119	97153, 97153, 97153
215659f2-bb07-464f-a6a1-70c73d94d966	Amerigroup-TX	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
2702e6b1-729b-47e7-bfcf-a3cad55559cf	Meridian-IL	denied	CARC CO-198 · RARC N54	Authorization Required	Auth team CARC 198	97155, 97155
2a5cfeab-da6b-43a3-b5bd-db1c8d6ae9a4	BCBS-IL	denied	CARC PI-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97156
2e962e87-4a14-4361-960b-ef6ead2d59dd	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
2f8ecb72-8be6-4901-8ad1-26afd27fd0d3	UHC/UBH/Optum-FL	denied	CARC CO-96, CO-45 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97153

0 of 200 row(s) selected.