Denial · CARC 27
ELIGIBILITY · NORTHSTAR MUTUAL
Classification
| Field | Value |
|---|---|
| Primary CARC | 27 |
| All CARCs | 27 |
| Root cause | ELIGIBILITY |
| Owns the fix | Access Related |
| Appealable | yes |
| Recoverable | yes |
| Recommended action | Expenses incurred after coverage terminated. Check the enrolment span: if the member was covered on the service date this is wrongly denied and worth appealing. |
| Payer | NORTHSTAR MUTUAL |
| Denial date | 23 Nov 2025 |
| Appeal deadline | 22 May 2026 |
Denial workflow
| Field | Value |
|---|---|
| Current status | new |
| Appeal outcome | not recorded |
| Closure reason | not applicable |
What this denial means, and to whom
CARC 27 recurs across 4,020 denials
CARC 27 appears on 4,020 denials in the ingested corpus — 31.2% of 12,891 — carrying $1,738,436.15 withheld in total. By evidence result: record conflicts with the reason 2,799; dates consistent with the reason 1,068; reason and dates disagree 153. 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.
From: Count and denied value of every denial sharing CARC 27, 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 | PI/27 | 16.01 | withheld |