CARC · CO group

CO-22

This care may be covered by another payer per coordination of benefits

Contractual obligation; provider write-off unless appealed

What it means

The payer thinks it is secondary, not primary.

Likely cause

Stale insurance on file, a new commercial plan, or Medicare/Medicaid COB not updated at intake.

How to fix it

Re-verify eligibility, confirm primary payer order with the patient, bill primary first, then submit secondary with the primary's 835 data.

Revenue impact

Recoverable but slow; the biggest driver of 90+ day aging in behavioral health.

• coordination of benefits
• eligibility