Denial · CARC 18
DUPLICATE · NORTHSTAR MUTUAL
Classification
| Field | Value |
|---|---|
| Primary CARC | 18 |
| All CARCs | 18 |
| Root cause | DUPLICATE |
| Owns the fix | Billing Related |
| Appealable | yes |
| Recoverable | no |
| Recommended action | Exact duplicate. Confirm it is a duplicate rather than a distinct service on the same day. |
| Payer | NORTHSTAR MUTUAL |
| Denial date | 30 Mar 2025 |
| Appeal deadline | 26 Sep 2025 |
Denial workflow
| Field | Value |
|---|---|
| Current status | new |
| Appeal outcome | not recorded |
| Closure reason | not applicable |
What this denial means, and to whom
The care was for TOMAS QUINN, a dependent on this policy
The payer withheld $67.00 from the provider for this service. The 835 did not assign any of this adjustment to the patient, so nothing here was reported as the member's responsibility. RARC N130: Consult plan benefit documents/guidelines for information about restrictions for this service. Do not treat the denied amount as a patient bill on the strength of this remittance alone. If a bill arrives for it, ask the provider what correction or appeal is under way, and question any balance the remittance does not support.
From: 835 CAS adjustment group codes on this remittance; the 837P patient loop that identifies who was treated.
Limits: This says what the 835 reported, not what was billed. A later remittance, a secondary payer or a correction can each change what the member is asked to pay, and none of that is visible here.
Adjustments
| Level | Code | Amount | Counts as |
|---|---|---|---|
| line | OA/18 | 67.00 | withheld |