CARC Code

138

🔴 Hard Denial

Appeal procedures not followed or time limits not met.

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Occasional

Frequency

Recommended Action

Review appeal submission requirements and refile within allowed timeframe

Step-by-Step Resolution

  1. 1

    Pull submission logs from your clearinghouse or payer portal

  2. 2

    Gather all proof of timely filing: submission confirmation, rejection notices, prior payments

  3. 3

    Submit a formal appeal with timely filing evidence attached

  4. 4

    If proof is insufficient, review internal workflows to prevent future occurrences

  5. 5

    Document the appeal and set a follow-up reminder for 30 days

Payer-Specific Notes

How major payers handle CARC 138 in practice.

MetLife Dental

MetLife provides detailed denial reason codes — check EOB for supplemental information.

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