CARC Code
2
Coinsurance Amount
97%
Recovery Rate
1-3 days
Avg. Resolution
Easy
Difficulty
Very Common
Frequency
Recommended Action
Bill patient for coinsurance percentage
Step-by-Step Resolution
- 1
Confirm coinsurance percentage from patient's Summary of Benefits
- 2
Verify the allowed amount used to calculate coinsurance
- 3
Calculate patient responsibility: allowed amount × coinsurance %
- 4
Issue patient statement for the coinsurance amount
- 5
Do not bill more than the coinsurance shown on the EOB
Common Remark Codes (RARC)
These RARC codes often appear alongside CARC 2 on remittance advice.
→ Cap patient billing at the EOB coinsurance amount
Payer-Specific Notes
How major payers handle CARC 2 in practice.
Delta Dental
Coinsurance applies after deductible; often 20% for basic, 50% for major
Aetna Dental
Basic restorative: 20% coinsurance after deductible for in-network providers
Common 835 Combinations
CARC 2 most often appears with these Group Code + RARC combinations on 835 remittances.
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