CARC codes can be designated Preventable or Non-preventable. The Denial Analysis gives the opportunity to report on these separately which can help you create a better workflow for working A/R.
Preventable Denial/Processed As Primary
These are Denials that have been designated in CARC Management as a Denial that could have been prevented when the CARC is the Primary denial code.
- Grouped by CARC
- Encounters
- Number of Encounters: # Encounters with this CARC on the EOB.
- Percent of Denials: The CARC's percentage of all Encounter denials
- Percent of all Items: The CARC's percentage of all Encounters
- Claims
- Number of Claims: # Claims with this CARC on the EOB.
- Percent of Denials: The CARC's percentage of all Claim denials
- Percent of all Items: The CARC's % of all Claims
- Procedures
- Number of Procedures: # Procedures with this CARC on the EOB.
- Percent of Denials: The CARC's percentage of all Procedure denials
- Percent of all Items: % of all Procedures
- Allowed-Contracted: This is the contracted allowed amount that is loaded in your Allowed Fee Schedule. It is not the Allowed Amount on the EOB.
- PV (Preventable): Was this denial preventable? Y (Yes} or N (No)
- P (Primary): Was this the Primary CARC? Y (Yes} or N (No)
- Total Preventable Denials
Denial Analysis: Non-Preventable/Non-Primary CARC
These are Denials that have not been designated in CARC Management as a denial that could have been prevented where the CARC is not the Primary denial.