CARC Code
1
Deductible Amount
95%
Recovery Rate
1-3 days
Avg. Resolution
Easy
Difficulty
Very Common
Frequency
Recommended Action
Bill patient for deductible amount
Step-by-Step Resolution
- 1
Verify patient's deductible status and year-to-date accumulation
- 2
Cross-reference with the plan's Explanation of Benefits
- 3
Bill patient for the deductible amount shown on the EOB
- 4
Document deductible balance in patient account
- 5
Send patient statement within 30 days of claim adjudication
Common Remark Codes (RARC)
These RARC codes often appear alongside CARC 1 on remittance advice.
Payer-Specific Notes
How major payers handle CARC 1 in practice.
Delta Dental
Deductible typically applies per beneficiary per year; some plans waive for preventive
MetLife Dental
Check if deductible waived for diagnostic/preventive codes (1xxx series)
Cigna Dental
Deductible accumulation resets January 1; verify mid-year deductible status
Common 835 Combinations
CARC 1 most often appears with these Group Code + RARC combinations on 835 remittances.
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