Denial · CARC 109
COB · NORTHSTAR MUTUAL
Denied
159.94
Withheld
Recoverable
159.94
Realistically collectable
Net of rework
128.94
less 31.00
Appeal window
closed 515d ago
Closed
Classification
| Field | Value |
|---|---|
| Primary CARC | 109 |
| All CARCs | 109 |
| Root cause | COB |
| Owns the fix | Access Related |
| Appealable | yes |
| Recoverable | yes |
| Recommended action | Not covered by this payer. Resubmit to the correct payer rather than appealing. |
| Payer | NORTHSTAR MUTUAL |
| Denial date | 27 Oct 2024 |
| Appeal deadline | 25 Apr 2025 |
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 Access Related
The remittance carries CARC 109, and the claim was adjudicated by NORTHSTAR MUTUAL. 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
| Level | Code | Amount | Counts as |
|---|---|---|---|
| line | PI/109 | 159.94 | withheld |