DenialIntel

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Denials›COB›claim B04M000841

Denial · CARC 109

COB · NORTHSTAR MUTUAL

Denied
37.06
Withheld
Recoverable
37.06
Realistically collectable
Net of rework
6.06
less 31.00
Appeal window
closed 25d ago
Closed

Classification

FieldValue
Primary CARC109
All CARCs109
Root causeCOB
Owns the fixAccess Related
Appealableyes
Recoverableyes
Recommended actionNot covered by this payer. Resubmit to the correct payer rather than appealing.
PayerNORTHSTAR MUTUAL
Denial date1 Mar 2026
Appeal deadline28 Aug 2026

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

Is this isolated or recurring?

CARC 109 recurs across 249 denials

CARC 109 appears on 249 denials in the ingested corpus — 1.9% of 12,891 — carrying $87,948.54 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 109, 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
linePI/10937.06withheld