RARC · CO group
MA04
Secondary payment cannot be considered without the primary payer's information
Contractual obligation; provider write-off unless appealed
- What it means
- The secondary claim went out without primary adjudication data.
- Likely cause
- Secondary billing automated before the primary 835 posted.
- How to fix it
- Gate secondary submission on primary remit posting, and include the primary's adjustment detail on the claim.
- Revenue impact
- Fully recoverable; a common cause of stalled secondary AR.
- RARC
- coordination of benefits
- secondary
Related codes
- CO-22This care may be covered by another payer per coordination of benefits
- OA-23The impact of prior payer(s) adjudication including payments and/or adjustments
- N130Consult plan benefit documents for information about restrictions for this service
- N290Missing, invalid, or incomplete rendering provider primary identifier
Early access
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Repeated MA04 adjustments usually point to a step before submission. First Pass Paid is building pre-submission checks and a denial worklist to catch these earlier.
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