Billing — Rejections
Rejection triage by CARC/RARC codes and denial reason (flow Step 5). Resolve and resubmit are money-actions.
Rejection triage by CARC/RARC codes and denial reason (flow Step 5). Resolve and resubmit are money-actions.
| Action | |||||||
|---|---|---|---|---|---|---|---|
| 5a912da8-035c-4fae-98fd-82304c306279 | Aetna-TX | denied | CARC PR-204 | Non-Covered Benefit | — | 97153 | |
| 713da99f-3577-4747-80e6-3a007c342284 | UMR-TX | denied | CARC PR-227, CO-45, OA-18, PR-27, CO-197 · RARC MA92, N702, N30 | Duplicate Claim | Billing — combine units CARC 18 | 97153, 97153 | |
| 30985ca6-6f09-4a86-b9c4-aefd0b95d652 | BCBS OF TX | denied | CARC CO-45 | — | — | 97153 | |
| 21d05825-3b3e-4354-8382-d671c65ff060 | Aetna-TX | denied | CARC PR-204 | Non-Covered Benefit | — | 97153 | |
| 3351d6c3-7d66-4f49-b355-fc0fa76113e9 | Aetna-TX | denied | CARC CO-197, CO-45, PR-27 · RARC N650 | Authorization Required; No Active Coverage | Auth team CARC 197 | 97153, 97153 | |
| 49edb391-8861-45ab-9f6a-b4bf4f73a6c5 | UHC Community Plan | denied | CARC PI-29 | Timely Filing | AR — appeal CARC 29 | 97153, 97153 | |
| 7a6245d2-6ee9-495e-ad2d-181819531fe2 | Community Health Choice | denied | CARC CO-18, CO-45 | Duplicate Claim | Billing — combine units CARC 18 | 97153, 97153 | |
| 8ce7f624-3085-44a1-8b01-06d35467c570 | Cooks Children's Health Plan TX | denied | CARC CO-29 | INCORRECT_OR_MISSING_INSURANCE_INFORMATION; Timely Filing | AR — appeal CARC 29 | 97153 | |
| bdff27ea-65b5-4833-a5af-80e694b5835a | Cigna-TX | denied | CARC PI-97, CO-45, CO-119, OA-94 · RARC N362, N130 | Max Benefit Reached | AR — revenue integrity CARC 97 | 97151 | |
| d1c47fe1-b2d7-428c-aaea-9f63ffdaa5d0 | Aetna Better Health-TX | denied | CARC OA-18 | Duplicate Claim | Billing — combine units CARC 18 | 97153, 97153 | |
| d745ba34-6dbf-470e-afbc-60de7c911f5b | Aetna-TX | denied | CARC CO-197, PR-27 · RARC N650 | Authorization Required | Auth team CARC 197 | 97155 | |
| f156a120-3290-4f08-aea3-4c0699a24be7 | Aetna-IL | denied | CARC CO-B13 | UNKNOWN; Duplicate Claim | Billing — combine units text: duplicate claim | 97153, 97153 | |
| 5590a7bd-bdb5-410e-af18-dcdfc9fdf082 | BCBS OF TX | denied | CARC CO-B11, CO-45 · RARC M115, N418 | UNKNOWN; No Effective Contract | — | 97153 | |
| 975ca9a0-7311-4b80-9a1c-ad826933551e | Cigna-TX | denied | CARC PI-97, OA-94, CO-198, CO-119 · RARC N362, N130, N435 | Authorization Required | AR — revenue integrity CARC 97 | 97153 | |
| 9937ab6a-2700-4e35-b3d7-d813aba626d0 | UMR-TX | denied | CARC PR-227, CO-45, PI-252, OA-94 · RARC MA92, M127, M15 | Info Requested from Provider | — | 97153, 97153 | |
| 0dfc0a3d-a691-4670-8f20-f0bb4f1bb62e | BCBS OF TX | denied | CARC CO-B11, CO-45 · RARC M115, N418, N519 | UNKNOWN; No Effective Contract | — | 97155 | |
| 27003662-d51a-42a5-80a1-fa224527085c | BCBS OF TX | denied | CARC CO-B11, CO-45 · RARC M115, N418, N519 | UNKNOWN; No Effective Contract | — | 97156 | |
| 2fbde66b-af2a-415c-b40f-f211297e0190 | Florida Blue | denied | CARC CO-96, CO-45, OA-97, OA-94 · RARC N381, N130 | Full Contractual Adjustment; Non-Covered Benefit | VOB team CARC 96 | 97151, 97151 | |
| 55333b57-99fc-4bc2-ba8c-a434c8625ae5 | Cigna-FL | denied | CARC PI-97, OA-94, CO-45, CO-119 · RARC N362, N130 | Max Benefit Reached | AR — revenue integrity CARC 97 | 97153, 97153 | |
| 67123edd-7355-47aa-8c2c-a22857e0f915 | Amerigroup-TX | denied | CARC CO-45, CO-96 · RARC N362, N381 | Non-Covered Benefit; Full Contractual Adjustment | VOB team CARC 96 | 97155, 97155 | |
| 8d693b8a-be88-4d47-9881-b7c07f356d28 | BCBS OF TX | denied | CARC CO-B13, CO-45, CO-222 · RARC N640 | Duplicate Claim | Billing — combine units text: duplicate claim | 97153 | |
| 8e0cc340-70d4-4661-a34c-bf1e024c3bf4 | Aetna-TX | denied | CARC PR-151 · RARC N123, N640 | Exceeded Billable Time | Billing — unit check CARC 151 | 97153, 97153, 97153 | |
| a14f0dac-b940-47ec-83c5-41f56211375f | Meridian-IL | denied | CARC CO-198, CO-16 · RARC N362, N255 | Authorization Required | Auth team CARC 198 | 97151 | |
| a542025c-81af-4c46-ad4e-cea27b978323 | BCBS OF TX | denied | CARC CO-B11, CO-45 · RARC M115, N418, N519 | UNKNOWN; No Effective Contract | — | 97156 | |
| a97a7346-63e1-4ec5-baa4-a79c40561f9f | Cigna-TX | denied | CARC CO-198, OA-94 · RARC N435 | Authorization Required | Auth team CARC 198 | 97153, 97153 |
0 of 200 row(s) selected.