Billing — Rejections

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


8dd2dc8b-841f-4c50-8648-f3a4554f32a4	Superior Health Plan-TX	denied	CARC CO-45, CO-119 · RARC N587	Max Benefit Reached	VOB team CARC 119	97155
8f30c398-6e42-4e0d-98ad-710082e45a1b	Amerigroup-TX	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
94c0204c-231c-4618-a6d7-b56723746c93	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
9fc957bb-55bd-4c1d-b73f-96e6926d9ad7	Amerigroup-TX	denied	CARC CO-45, CO-198 · RARC N362, N381	Authorization Required	Auth team CARC 198	97156
a2b39199-69b9-4dbd-9988-81a88e93bbbe	Anthem BCBS-GA	rejected	—	UNKNOWN	—	97153, 97155
a6c15aa2-96f3-4ee0-b1bb-eb4ddbaf9339	Oscar Health-FL	denied	CARC CO-252 · RARC M127	Info Requested from Provider	—	97153, 97153, 97153
aa6c3680-8e21-4191-88a0-b273d7b58fec	Alameda Alliance for Health	denied	CARC CO-45, PI-45 · RARC N644	Full Contractual Adjustment	—	H2012
b7c17886-64d7-4224-b37f-54a6ac9d49d7	BCBS TX MCO	denied	CARC CO-131, PI-151 · RARC N381	Exceeded Billable Time	Billing — unit check CARC 151	97153
bf4a93d0-e935-4801-b684-3fc2d662ecfc	Peach State Health Plan	rejected	—	UNKNOWN	—	97153, 97153, 97153
c37b7909-3ef4-4061-8e68-ed1a209e2a9a	BCBS-IL	denied	CARC CO-45, CO-96 · RARC N362, N381	Credentialing; Non-Covered Benefit	VOB team CARC 96	97153, 97153
c5c4780c-1fe1-470d-bf62-5260720c2e4a	Molina-TX	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97151
d417fa9f-7898-494e-997e-06d1f198fb80	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153, 97153
eb024b6d-fc37-4b90-b8ca-cbc805f28ac8	Aetna-IL	denied	CARC CO-29	Timely Filing	AR — appeal CARC 29	97155, 97155
ed172f64-0ac0-41ec-b317-08429838c207	BCBS MCO-IL	denied	CARC PI-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
fb7bb55b-5f27-4a2b-8c45-68c93b06930e	Cigna-IL	denied	CARC OA-94, CO-45, PI-97, CO-119 · RARC N362, N130	Max Benefit Reached	AR — revenue integrity CARC 97	97155, 97155
01c5f456-de17-46af-b16d-c166c98dd79f	BCBS OF TX	denied	CARC OA-18 · RARC N702	Duplicate Claim	Billing — combine units CARC 18	97153
03893f1d-b7c7-42bb-b905-2344830d31ed	Superior Health Plan-TX	denied	CARC CO-45, CO-119 · RARC N587	Max Benefit Reached	VOB team CARC 119	97153, 97153
04d467c8-b3e7-4114-9fc9-98e5a74f5f48	Aetna Better Health-TX	denied	CARC CO-45, OA-18	Duplicate Claim	Billing — combine units CARC 18	97153
15fd5967-011d-4a47-85bd-9a829e42c97b	UHC Community Plan	denied	CARC CO-251, CO-96 · RARC N188, M127	Non-Covered Benefit	VOB team CARC 96	97153, 97153, 97153
16006204-9961-4150-8b38-17fee81c7256	BCBS OF TX	denied	CARC CO-222 · RARC N640	Exceeded Billable Time	—	97153
1986b36b-47a9-4079-98f1-fcaa8e366250	UHC/UBH/Optum-FL	denied	CARC PR-227 · RARC N479	Info Requested from Patient	—	97156
2b4cf70e-03bf-4a1b-825a-713421d029fe	UHC Community Plan	denied	CARC CO-252 · RARC N707	Info Requested from Provider	—	97155
2f1b4d56-5bce-4f8c-80d7-09c71523b8e6	UHC/UBH/Optum-TX	denied	CARC CO-150 · RARC N640	Incorrect Procedure Code	—	97155
49537633-aab9-4bb7-85b3-0acc0b3fce9d	UHC Community Plan	denied	CARC CO-45, CO-96 · RARC N188	Full Contractual Adjustment; Non-Covered Benefit	VOB team CARC 96	97153, 97153, 97153
6a5fb9cc-7a10-4278-99f6-bb86b5d95f1f	UHC/UBH/Optum-FL	denied	CARC PR-227 · RARC N479	Info Requested from Patient	—	97153

0 of 200 row(s) selected.