DenialIntel

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Denials›DUPLICATE›claim B09M000452

Denial · CARC 18

DUPLICATE · CASCADE CARE

Denied
186.00
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
closed 466d ago
Closed

Classification

FieldValue
Primary CARC18
All CARCs18
Root causeDUPLICATE
Owns the fixBilling Related
Appealableyes
Recoverableno
Recommended actionExact duplicate. Confirm it is a duplicate rather than a distinct service on the same day.
PayerCASCADE CARE
Denial date13 Jun 2024
Appeal deadline13 Jun 2025

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

What should I investigate, and how urgent is it?

The modelled appeal window passed 466 days ago

The 835 reports CARC 18 on 13 Jun 2024, withholding $186.00 from the provider. Modelled recoverable $0.00, less an estimated rework cost of $31.00, leaves $0.00 net. The configured appeal window for this payer ends 13 Jun 2025, 466 days ago. Recommended action: Exact duplicate. Confirm it is a duplicate rather than a distinct service on the same day. Confirm the contractual deadline and any exception, reconsideration or correction route with the payer before closing the case.

From: Denial derivation: root cause, appealability, the recoverable amount net of an estimated rework cost, and a filing deadline derived from the denial date.

Limits: The deadline and the recoverable amount are application estimates. The deadline is the denial date plus a configured per-payer window, not a term read from the payer's contract or an appeal notice, and the recoverable figure is a model rather than a promise of payment. Confirm both against the policy before relying on them.

Adjustments

LevelCodeAmountCounts as
lineOA/18186.00withheld