DenialIntel

Demo Environment — Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Denials›DUPLICATE›claim B02M000893

Denial · CARC 18

DUPLICATE · NORTHSTAR MUTUAL

Denied
651.00
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
31
Days left

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.
PayerNORTHSTAR MUTUAL
Denial date26 Apr 2026
Appeal deadline23 Oct 2026

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

Which team should investigate first?

Route first to Billing Related

The remittance carries CARC 18, and the claim was adjudicated by NORTHSTAR MUTUAL. The application maps CARC 18 to Billing Related using the originating-area reference. This class of denial is corrected by Billing Related rather than at registration. Check with that team before assuming a front-desk cause.

From: CARC 18 mapped to an owning department through the originating-area reference.

Limits: This is a routing recommendation, not a root-cause finding. The problem could arise from registration data, a later enrolment change, an interface mismatch, or the payer's own adjudication, and this mapping distinguishes none of them.

Adjustments

LevelCodeAmountCounts as
lineOA/18651.00withheld