Billing — Rejections

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


9a163c48-84af-40a2-96a9-88b5fe9a25d4	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153, 97153
9e0e9d1f-b6ef-4f61-a56f-c4096ec412eb	Superior Health Plan-TX	denied	CARC CO-22 · RARC N4	Coordination of Benefits	VOB team CARC 22	97153, 97153
9eaf556e-c0da-434f-88bf-29c17ca18a33	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97156
a0468d1d-460f-48e6-9009-4b3c5475b13b	Superior Health Plan-TX	denied	CARC CO-119 · RARC N362	Max Benefit Reached	VOB team CARC 119	97155
a214c7ec-f610-4eb5-b34c-1b13a2201a4a	Anthem BCBS-GA	denied	CARC CO-226 · RARC M127	Info Requested from Provider	—	97153, 97153
c2ca9116-acdc-4bce-bc30-e508e92f5852	Texas Children's Health Plan MCO-TX	denied	CARC CO-B7 · RARC N767	Credentialing	Credentialing team CARC B7	97155
cd50189b-9552-4e6f-88b4-707347266f12	Partnership HealthPlan of California	denied	CARC CO-B11	Incorrect Payer	—	97151
d634eb10-d4ec-46d1-af53-9ebb897bbd5d	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153, 97153, 97153
d70d3f82-8ddf-4746-b6a6-30d7f27bf067	Texas Children's Health Plan MCO-TX	denied	CARC CO-B7 · RARC N767	Credentialing	Credentialing team CARC B7	97155
d94c556f-786a-4399-b032-3b45d162b0c0	UHC Community Plan	denied	CARC CO-96 · RARC N188, N362	Non-Covered Benefit	VOB team CARC 96	97153, 97153
dc1c5020-b021-428f-a3e8-55e246c25d1c	Health Plan of San Mateo	denied	CARC CO-197	Authorization Required	Auth team CARC 197	97156, 97155
e82afcb4-197c-4942-b912-190bce8bae0a	UHC/UBH/Optum-FL	denied	CARC CO-96, CO-45 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97153
eaebd556-b3d1-4b75-aba5-04a4481efd23	Health Plan of San Mateo	denied	CARC CO-96 · RARC N54	Non-Covered Benefit	VOB team CARC 96	97155
f6c231bb-13fa-47cc-b7c3-56d155baa353	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
f96b18cf-109c-4f96-978d-10b8c1c837c3	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97156
20610efc-75c3-4221-b787-1598d393731b	Tricare East - FL	denied	CARC CO-96 · RARC M80	Non-Covered Benefit	VOB team CARC 96	97153
2525f3fb-3ae3-4b49-aa1d-6bdca6d3f1fc	Amerigroup-TX	denied	CARC CO-197	Authorization Required	Auth team CARC 197	97151, 97151
2b10d7d4-fd86-461c-8774-602deab23f48	Amerigroup-TX	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
315aa424-ebb7-41d7-9bfc-f3fe930325da	UHC/UBH/Optum-TX	denied	CARC CO-197, CO-45	Authorization Required	Auth team CARC 197	97151
31d1b33a-9ce1-4db5-b363-2debe6c9f2e6	Alameda Alliance for Health	denied	CARC CO-39 · RARC M76	Authorization Required	Billing — clearinghouse CARC 39	S5111
34689f08-dec2-4ea6-9f94-89127b681789	Cigna-TX	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	00000, 00000
34fb5b40-4929-447e-a010-1127163fd3ef	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153
45260e72-bbce-49ac-a3e5-073bc8e4b6b0	UHC Community Plan	denied	CARC CO-256 · RARC N448	No Effective Contract	—	97153, 97153, 97153
479c9abc-e895-4c6a-89de-b6e0a286439e	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97155
4bb1ba8a-ad29-43a7-b66a-844df85a9a63	BCBS OF TX	denied	CARC CO-96 · RARC N10	Non-Covered Benefit	VOB team CARC 96	97153, 97153

0 of 200 row(s) selected.