How do I resolve a CO-301 denial?

Review the full denial on the 835 ERA for CARC 301: "Claim received by the Medical Plan, but benefits not available under this plan." Pull the original claim and all supporting documentation for the date of service. See full resolution steps at tryarceum.com.

Can I appeal a CO-301 denial?

CO-301 denials are generally not appealable. This is a contractual carve-out indicating the wrong payer was billed, not a coverage determination that can be appealed.

CARC Code

301

🟡 Soft Denial

Benefits Under Behavioral Health Plan

The medical insurance plan received the claim but does not cover these services because they fall under the patient's separate behavioral health insurance plan. The claim needs to be sent to the behavioral health insurer instead.

contractual

Resolution: 85%Easy difficulty3-7 days avg

How to resolve this denial

Which payer denied this claim?

Review and resolve CARC 301: Claim received by the Medical Plan, but benefits not available under this plan.

1
Review the full denial on the 835 ERA for CARC 301: "Claim received by the Medical Plan, but benefits not available under this plan."
2
Pull the original claim and all supporting documentation for the date of service.
3
Identify the specific data element, policy requirement, or documentation gap that triggered this adjustment.
4
Correct the identified issue — update claim data, gather missing documentation, or verify coverage details.
5
Resubmit as a corrected claim (frequency type 7) or file a written appeal with supporting documentation.
6
Follow up with the payer within 10-15 business days to confirm adjudication.

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▶✓ 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-301 — stats, related codes, appeal template

85%

Recovery Rate

3-7 days

Avg. Resolution

Easy

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 301 by specialty.

General

Confirm payer-specific policy for CARC 301 and submit corrected claim or appeal as appropriate.

Appeal Letter Template

Generic appeal template for CARC 301 denials.

Dear [Payer Name] Appeals Department, We are writing to appeal the denial of claim [CLAIM #] for patient [PATIENT NAME] (Member ID: [ID]) for services rendered on [DATE OF SERVICE]. The claim was denied with CARC 301: "Claim received by the Medical Plan, but benefits not available under this plan." We believe this denial is in error for the following reasons: [INSERT CLINICAL/ADMINISTRATIVE JUSTIFICATION] We respectfully request reconsideration and payment of this claim. Sincerely, [Provider Name / Billing Contact]

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