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›COB›claim B05M000711

Denial · CARC 109

COB · CASCADE CARE

Denied
784.00
Withheld
Recoverable
784.00
Realistically collectable
Net of rework
753.00
less 31.00
Appeal window
329
Days left

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.
PayerCASCADE CARE
Denial date17 Aug 2026
Appeal deadline17 Aug 2027

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 Access Related

The remittance carries CARC 109, and the claim was adjudicated by CASCADE CARE. The application maps CARC 109 to Access Related using the originating-area reference. Review the policy selected for the encounter, the coverage effective dates available at registration, and any eligibility response captured before the service.

From: CARC 109 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
linePI/109784.00withheld