Denial · CARC 96
NON_COVERED · MERIDIAN HEALTH PLAN
Classification
| Field | Value |
|---|---|
| Primary CARC | 96 |
| All CARCs | 96,45 |
| Root cause | NON_COVERED |
| Owns the fix | Utilization |
| Appealable | yes |
| Recoverable | no |
| Recommended action | Non-covered charge. Read the RARC: some are appealable, most are not. |
| Payer | MERIDIAN HEALTH PLAN |
| Denial date | 15 Sep 2024 |
| Appeal deadline | 14 Dec 2024 |
Denial workflow
| Field | Value |
|---|---|
| Current status | new |
| Appeal outcome | not recorded |
| Closure reason | not applicable |
What this denial means, and to whom
CARC 96 recurs across 736 denials
CARC 96 appears on 736 denials in the ingested corpus — 5.7% of 12,891 — carrying $136,024.22 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 96, 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
| Level | Code | Amount | Counts as |
|---|---|---|---|
| line | PR/96 | 358.15 | write-off |
| line | CO/45 | 192.85 | write-off |