What does CARC 31 mean?

CARC 31 means "Patient cannot be identified as our insured.". The recommended action is: Verify patient demographics and insurance ID, correct and resubmit.

How do I resolve CARC 31?

Call the patient to verify their current insurance information Verify member ID, date of birth, and name spelling against the insurance card Run an eligibility check using the corrected information Correct the patient demographics in your practice management system Resubmit the claim with corrected patient identifier information Update the patient's file with verified insurance information going forward

Can CARC 31 be appealed?

CARC 31 has a 82% recovery rate and typically resolves in 5-14 days. Resolution difficulty is rated Medium.

CARC Code

31

🔴 Hard Denial

Patient cannot be identified as our insured.

82%

Recovery Rate

5-14 days

Avg. Resolution

Medium

Difficulty

Occasional

Frequency

Recommended Action

Verify patient demographics and insurance ID, correct and resubmit

Step-by-Step Resolution

1
Call the patient to verify their current insurance information
2
Verify member ID, date of birth, and name spelling against the insurance card
3
Run an eligibility check using the corrected information
4
Correct the patient demographics in your practice management system
5
Resubmit the claim with corrected patient identifier information
6
Update the patient's file with verified insurance information going forward

Common Remark Codes (RARC)

These RARC codes often appear alongside CARC 31 on remittance advice.

RARC N382·Missing/incomplete/invalid patient identifier

→ Correct member ID, DOB, or name on the claim

RARC N1·Alert: Refer to provider manual for additional guidance

→ Verify patient search criteria with payer directly

Payer-Specific Notes

How major payers handle CARC 31 in practice.

Delta Dental

Member ID format varies by state; do not add prefix/suffix unless payer-specific

BCBS Dental

Federal Employee Program uses different ID format; verify FEP vs. commercial

Common 835 Combinations

CARC 31 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-31

Look up any combination →

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