CARC Code
106
Payment Option Not Elected
The patient had the opportunity to choose a specific payment option or arrangement, but either did not make that election or it is no longer active. The claim cannot be processed under a payment plan or option that was never selected or has expired.
patient responsibilityHow to resolve this denial
Review patient payment election and correct benefit assignment
- 1
Pull the original claim and review the denial reason and any RARC codes
- 2
Research the payer's policy for CARC 106 to understand the basis for denial
- 3
Gather supporting documentation addressing the denial reason
- 4
Submit a formal appeal with the documentation within the plan's appeal window
- 5
Follow up on the appeal within 30 days and document all communication
▶✓ Pre-action checklist — verify before contacting the payer
Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.
▶More about CO-106 — stats, related codes, appeal template
55%
Recovery Rate
14-30 days
Avg. Resolution
Medium
Difficulty
Rare
Frequency
Payer-Specific Notes
How major payers handle CARC 106 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Appeal Letter Template
Generic appeal template for CARC 106 denials.
We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 106 indicating: "Patient payment option/election not in effect.." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.
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