How do I resolve a CO-195 denial?

Review the remittance advice to confirm the adjustment amount is accurate Verify the contractual write-off against your fee schedule See full resolution steps at tryarceum.com.

Can I appeal a CO-195 denial?

CO-195 denials are generally not appealable. This is an administrative correction to fix incorrect payer priority, not a denial of coverage or payment amount that can be appealed.

CARC Code

195

🔵 Informational

Refund to Incorrect Priority Payer

The insurance company is sending money back to another payer who paid this claim by mistake because they should not have been the primary payer. The payment is being returned so the correct insurance company can pay instead.

contractual

Resolution: 99%Easy difficulty1-3 days avg

How to resolve this denial

Which payer denied this claim?

Accept — payer correcting a prior misrouted payment; verify refund receipt

1
Review the remittance advice to confirm the adjustment amount is accurate
2
Verify the contractual write-off against your fee schedule
3
Post the adjustment to the patient account
4
Do not balance bill the patient for this contractual reduction
5
Document the adjustment in your billing system

Resolve this denial →

▶✓ 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-195 — stats, related codes, appeal template

99%

Recovery Rate

1-3 days

Avg. Resolution

Easy

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 195 by specialty.

UnitedHealthcare

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

Common 835 Combinations

CARC 195 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-195This code appears when the payer has issued a refund to a previously identified COCO-195+N14A refund has been issued to a payer that was incorrectly listed as primary for

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 195 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 195 indicating: "Refund issued to erroneous priority payer for this claim/service.." 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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