X12 Ingest & Denial Analytics

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Denials›DUPLICATE›claim B10M000532

Denial · CARC 18

DUPLICATE · MERIDIAN HEALTH PLAN

Denied
896.00
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
closed 773d 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.
PayerMERIDIAN HEALTH PLAN
Denial date12 May 2024
Appeal deadline10 Aug 2024

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

Is this isolated or recurring?

CARC 18 recurs across 1,190 denials

CARC 18 appears on 1,190 denials in the ingested corpus — 9.2% of 12,891 — carrying $536,207.40 withheld in total. This volume warrants a management investigation across payers, services, locations and evidence results. The shared CARC does not yet establish a shared cause or a single corrective action. Split these cases by evidence result before choosing an intervention, then compare by payer, specialty, location and period.

From: Count and denied value of every denial sharing CARC 18, across the ingested remittances.

Limits: These are counts within the loaded corpus and its reporting period, not the full book of business. A shared reason code is recurrence, not a shared cause: the cases grouped here may arise from different payers, services and failures, and no department is implicated by the count alone.

Adjustments

LevelCodeAmountCounts as
lineOA/18896.00withheld