Billing — Rejections

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


67af67d1-8015-434a-89ba-f18d03fb4388	BCBS OF TX	denied	CARC CO-96 · RARC N10	Non-Covered Benefit	VOB team CARC 96	97153, 97153, 97153
7d730109-dd6a-45b3-9eb8-179d5f4ce77a	Superior Health Plan-TX	denied	CARC CO-208 · RARC N255	Credentialing	—	97155
82f8beed-37c7-4862-84f2-882d82b3ff0a	Anthem BCBS-GA	denied	CARC CO-198, CO-45, PR-2 · RARC N640	Authorization Required	Auth team CARC 198	97156
832dbd50-869c-43fe-a244-34d15fde9aec	UHC Community Plan	denied	CARC CO-B7	Credentialing	Credentialing team CARC B7	97153
885bb7fd-49d7-4893-9f11-3f007f08619b	Superior Health Plan-TX	denied	CARC CO-208 · RARC N255	Credentialing	—	97155
8cd13a6b-f95b-4d52-a9a0-f722dd524807	Anthem BCBS-GA	denied	CARC CO-198 · RARC N54	Authorization Required	Auth team CARC 198	97153
8fb2c2a2-38a1-4be3-8fb7-13d453333818	UHC Community Plan	denied	CARC CO-150 · RARC N640	Incorrect Procedure Code	—	97155
a53ee9dc-01df-480c-97e1-4901f9e440c5	Molina-CA-SCA	denied	CARC CO-B7, CO-206 · RARC N257, N570	Credentialing; Invalid Provider Information	Credentialing team CARC B7	S5111, H0046
aa2e0f38-6197-4596-ae78-e26695901269	UHC Community Plan	denied	CARC CO-256 · RARC N448	No Effective Contract	—	97153, 97153
afac3e56-4638-4d28-97e3-edaa83570eca	Peach State Health Plan	denied	CARC CO-45, CO-119 · RARC N587	Max Benefit Reached	VOB team CARC 119	97151
b8d57000-fbeb-4191-a8e9-de69c41ee5a1	Health Plan of San Mateo	denied	CARC CO-197	Authorization Required	Auth team CARC 197	S5111
bb424b7b-46ce-4d2e-838f-fe7fca23e05f	Peach State Health Plan	denied	CARC CO-198 · RARC N54	Authorization Required	Auth team CARC 198	97153, 97153, 97153
bf11b087-374d-48cd-bce9-6ce43132965b	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
c44c7b8e-939e-4316-b214-eed031a32562	Texas Children's Health Plan MCO-TX	denied	CARC CO-B7 · RARC N767	Credentialing	Credentialing team CARC B7	97153, 97153, 97153
c9be5120-0fe8-43f5-99e9-16f93edd3594	UHC Community Plan	denied	CARC CO-96 · RARC N362	Non-Covered Benefit	VOB team CARC 96	97155
e6d83a3c-8acf-4783-aafb-9261225f3e9e	Anthem BCBS-GA	rejected	—	UNKNOWN	—	97155, 97153
f0b13ea4-a7a5-40d1-a5c5-080c3e829a83	Partnership HealthPlan of California	denied	CARC CO-4	Invalid Modifier	Billing — fix in Candid CARC 4	97153
fe1a5fa6-673a-47d3-bea6-bf6684d1258c	Health Plan of San Mateo	denied	CARC CO-96 · RARC N54	Non-Covered Benefit	VOB team CARC 96	97155
feb39d26-f268-44c5-8d20-e7b1225f629f	UHC Community Plan	denied	CARC CO-96 · RARC N188	Non-Covered Benefit	VOB team CARC 96	97153
11c25a94-c2a1-4f96-ab57-f133011fa29e	UHC/UBH/Optum-FL	denied	CARC CO-226 · RARC N26	Info Requested from Provider	—	97155
1b315d61-4659-4eaa-8535-1abf71f7807e	Health Plan of San Mateo	denied	CARC CO-197 · RARC MA130	Authorization Required	Auth team CARC 197	H0046, S5111
28b41473-7ae2-4f36-bf82-2743c06c880f	UMR-FL	denied	CARC OA-18 · RARC N702	Duplicate Claim	Billing — combine units CARC 18	97153
2b44c02b-efb0-4b1c-be6b-22dff1a85928	Anthem MediCal-CA	denied	CARC CO-198, CO-45 · RARC N442, N640	Authorization Required	Auth team CARC 198	97155
37081949-c2e8-4290-a11d-4a3dd063be46	Community Health Choice	denied	CARC CO-8 · RARC N95	Incorrect Procedure Code	—	97153, 97153
569910b0-00ef-42eb-9f1e-ab018175be5e	Health Plan of San Mateo	denied	CARC CO-197	Authorization Required	Auth team CARC 197	S5111

0 of 200 row(s) selected.