CARC Code
111
Coverage Requires Accepting Assignment
This service or item is only covered by the insurance plan if the provider agrees to accept assignment, meaning they accept the insurance payment as payment in full and cannot balance bill the patient beyond allowed cost-sharing amounts.
contractualHow to resolve this denial
Verify assignment status; accept assignment or bill patient if non-par
- 1
Verify the rendering or referring provider's enrollment status with this payer
- 2
Check that the provider's NPI, taxonomy, and license are current and active
- 3
If the provider is not enrolled, initiate enrollment before resubmitting
- 4
Obtain a re-referral or re-order from an enrolled, eligible provider if needed
- 5
Resubmit the claim with the correct enrolled provider information
▶✓ 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-111 — 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 111 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Appeal Letter Template
Generic appeal template for CARC 111 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 111 indicating: "Not covered unless the provider accepts assignment.." 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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