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 B06M000611

Denial · CARC 18

DUPLICATE · CASCADE CARE

Denied
377.00
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
314
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.
PayerCASCADE CARE
Denial date2 Aug 2026
Appeal deadline2 Aug 2027

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

What should I investigate, and how urgent is it?

Appealable · $0.00 modelled net of rework

The 835 reports CARC 18 on 2 Aug 2026, withholding $377.00 from the provider. Modelled recoverable $0.00, less an estimated rework cost of $31.00, leaves $0.00 net. The configured appeal window for this payer ends 2 Aug 2027, in 314 days. Recommended action: Exact duplicate. Confirm it is a duplicate rather than a distinct service on the same day. Confirm the contractual deadline and any exception, reconsideration or correction route with the payer before closing the case.

From: Denial derivation: root cause, appealability, the recoverable amount net of an estimated rework cost, and a filing deadline derived from the denial date.

Limits: The deadline and the recoverable amount are application estimates. The deadline is the denial date plus a configured per-payer window, not a term read from the payer's contract or an appeal notice, and the recoverable figure is a model rather than a promise of payment. Confirm both against the policy before relying on them.

Adjustments

LevelCodeAmountCounts as
lineOA/18377.00withheld