X12 Ingest & Denial Analytics

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Denials›NON_COVERED›claim B07M000097

Denial · CARC 96

NON_COVERED · MERIDIAN HEALTH PLAN

Denied
17.40
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
32
Days left

Classification

FieldValue
Primary CARC96
All CARCs96
Root causeNON_COVERED
Owns the fixUtilization
Appealableyes
Recoverableno
Recommended actionNon-covered charge. Read the RARC: some are appealable, most are not.
PayerMERIDIAN HEALTH PLAN
Denial date26 Jul 2026
Appeal deadline24 Oct 2026

Denial workflow

FieldValue
Current statusnew
Appeal outcomenot recorded
Closure reasonnot applicable

What this denial means, and to whom

Does this mean I owe money?

The care was for BRIAN FOSTER, a dependent on this policy

The payer withheld $17.40 from the provider for this service. The 835 did not assign any of this adjustment to the patient, so nothing here was reported as the member's responsibility. RARC N130: Consult plan benefit documents/guidelines for information about restrictions for this service. Do not treat the denied amount as a patient bill on the strength of this remittance alone. If a bill arrives for it, ask the provider what correction or appeal is under way, and question any balance the remittance does not support.

From: 835 CAS adjustment group codes on this remittance; the 837P patient loop that identifies who was treated.

Limits: This says what the 835 reported, not what was billed. A later remittance, a secondary payer or a correction can each change what the member is asked to pay, and none of that is visible here.

Adjustments

LevelCodeAmountCounts as
linePI/9617.40withheld