CARC Code

248

🔵 Informational

Institutional Claim Professional Service Coinsurance

This is the patient's coinsurance responsibility for a professional service (like a physician's work) that was performed in a facility setting and billed by the facility. The patient must pay their share of the cost according to their insurance plan's coinsurance percentage.

patient responsibility
Resolution: 99%Easy difficulty1-3 days avg

How to resolve this denial

Accept AHRQ IPE adjustment — quality improvement initiative

  1. 1

    Review the remittance advice to confirm the adjustment amount is accurate

  2. 2

    Verify the contractual write-off against your fee schedule

  3. 3

    Post the adjustment to the patient account

  4. 4

    Do not balance bill the patient for this contractual reduction

  5. 5

    Document the adjustment in your billing system

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-248 — 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 248 by specialty.

UnitedHealthcare

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

Appeal Letter Template

Generic appeal template for CARC 248 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 248 indicating: "Adjustment for Healthcare Research and Quality — Inpatient Physician Error (IPE)." 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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