CARC Code

115

🟡 Soft Denial

Procedure Postponed, Canceled, or Delayed

The insurance company is denying or adjusting the claim because the scheduled procedure did not happen as planned—it was either postponed to a later date, canceled entirely, or delayed.

contractual
Resolution: 95%Easy difficulty3-7 days avg

How to resolve this denial

Identify the correct payer and resubmit; update billing records

  1. 1

    Verify whether the patient has coverage through another insurance plan

  2. 2

    Identify the correct payer order (primary, secondary, tertiary)

  3. 3

    Submit or resubmit the claim to the appropriate payer

  4. 4

    Include the primary payer's EOB when billing secondary insurance

  5. 5

    Document coordination of benefits information in the patient account

Resolve this denial →
✓ Pre-action checklist — verify before contacting the payer
  1. Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.

  2. Verify the claim was submitted with correct patient eligibility and benefit information.

  3. Check if this denial applies to a specific line item or the entire claim.

More about CO-115 — stats, related codes, appeal template

95%

Recovery Rate

3-7 days

Avg. Resolution

Easy

Difficulty

Occasional

Frequency

Payer-Specific Notes

How major payers handle CARC 115 by specialty.

UnitedHealthcare

Review UHC's online claim status tool for additional detail on this adjustment.

Appeal Letter Template

Generic appeal template for CARC 115 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 115 indicating: "Claim submitted to incorrect payer.." 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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