Billing — Rejections

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


343e323c-6866-4561-a2d8-bdd64f56d956	Aetna-IL	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97155
372b761b-1c2b-4dda-8377-0497d2e11eec	UHC Community Plan	denied	CARC CO-96 · RARC N188	Non-Covered Benefit	VOB team CARC 96	97153, 97153
38de8223-22f3-44ae-9be4-dc683a5adbd6	Amerigroup-TX	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
393a81e7-7cc6-4eea-a587-a05a9e10d9e3	UHC/UBH/Optum-FL	denied	CARC CO-197	Authorization Required	Auth team CARC 197	97153
3984bc8d-63c0-4867-af89-fbb0d74c840b	Superior Health Plan-TX	denied	CARC CO-119 · RARC N362	Max Benefit Reached	VOB team CARC 119	97155
39b30691-2fae-4730-9d2c-7e90367ec2d9	UHC Community Plan	denied	CARC CO-45, CO-197	Authorization Required	Auth team CARC 197	97153
3beca2ca-c6d1-4ca0-94df-04f572aeedc6	Anthem BCBS-GA	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97155
41edc2c0-978b-4c5d-832e-fc71ed195af8	UMR-CA	denied	CARC PI-252 · RARC N457, N221, N453, N220	Info Requested from Provider	—	97156
4885da18-7c11-4248-b3fd-83b3851b976f	Aetna-TX	denied	CARC CO-45, CO-119 · RARC N123, N640	Full Contractual Adjustment; Max Benefit Reached	VOB team CARC 119	97153, 97153, 97153
4c9f955f-d01a-4914-a618-a1ae4f6472d6	Anthem BCBS-GA	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97155
4f3b672c-8d70-4118-8f19-66d887cca3b6	Superior Health Plan-TX	denied	CARC CO-119 · RARC N362	Max Benefit Reached	VOB team CARC 119	97155
570e5c94-3d28-4137-b1d7-b4f6920f6479	BCBS OF TX	denied	CARC CO-B13	Duplicate Claim	Billing — combine units text: duplicate claim	97153, 97153
5b571677-7e68-4e85-9f6a-e730451a2820	Partnership HealthPlan of California	denied	CARC CO-B11	Incorrect Payer	—	97151, 97151
62fa88e9-fcc2-442f-9a47-672ef211f14c	Superior Health Plan-TX	denied	CARC CO-198 · RARC N54	Authorization Required	Auth team CARC 198	97153, 97153
67c8a7ba-0f52-4de7-84a4-e32ef7d45e6e	BCBS MCO-IL	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97153
700cda0c-dc19-4169-ae9a-16054b116a6c	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153, 97153
7517b4c8-5bef-4bd6-be81-a85310e6c7f3	UHC/UBH/Optum-FL	denied	CARC PR-227 · RARC N479	UNKNOWN; Info Requested from Patient	—	97153
7868306d-d4af-49ef-a74e-3438f02dcc63	BCBS MCO-IL	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97153
80f4b126-03a9-42e6-b503-8dad8820a14d	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153
85be59df-7bb2-449b-ac19-c7c7cb969ae9	UHC/Optum/AvMed-FL	denied	CARC PI-251 · RARC N705	Info Requested from Provider	—	97155
8f558671-a091-4594-8ec0-9f23fac40852	UHC/UBH/Optum-FL	denied	CARC PR-227 · RARC N479	UNKNOWN; Info Requested from Patient	—	97155
90312dd0-aa9e-41e5-a00b-de5df5999a45	UMR-CA	denied	CARC PI-252 · RARC N457, N221, N453, N220	Info Requested from Provider	—	97156
91b5ea4c-d137-462b-8896-28da6ed4ed9a	BCBS MCO-IL	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97153
97d64d94-5574-4835-bf19-090a96f88e70	Health Plan of San Mateo	denied	CARC CO-45, CO-97 · RARC M15	Bundled	AR — revenue integrity CARC 97	97152, 97151
a12345dd-3126-4e8e-b5a8-6c7326b9288e	Cigna-FL	denied	CARC OA-94, CO-119, PR-2, CO-45, PI-97 · RARC N362, N130	Max Benefit Reached	VOB team CARC 119	97151

0 of 200 row(s) selected.