Denial · CARC 18
DUPLICATE · MERIDIAN HEALTH PLAN
Denied
515.00
Withheld
Recoverable
0.00
Realistically collectable
Net of rework
0.00
less 31.00
Appeal window
closed 731d ago
Closed
Classification
| Field | Value |
|---|---|
| Primary CARC | 18 |
| All CARCs | 18 |
| Root cause | DUPLICATE |
| Owns the fix | Billing Related |
| Appealable | yes |
| Recoverable | no |
| Recommended action | Exact duplicate. Confirm it is a duplicate rather than a distinct service on the same day. |
| Payer | MERIDIAN HEALTH PLAN |
| Denial date | 23 Jun 2024 |
| Appeal deadline | 21 Sep 2024 |
Denial workflow
| Field | Value |
|---|---|
| Current status | new |
| Appeal outcome | not recorded |
| Closure reason | not applicable |
What this denial means, and to whom
Which team should investigate first?
Route first to Billing Related
The remittance carries CARC 18, and the claim was adjudicated by MERIDIAN HEALTH PLAN. The application maps CARC 18 to Billing Related using the originating-area reference. This class of denial is corrected by Billing Related rather than at registration. Check with that team before assuming a front-desk cause.
From: CARC 18 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
| Level | Code | Amount | Counts as |
|---|---|---|---|
| line | OA/18 | 515.00 | withheld |