835 Denial Combination

CO-140

CO

Contractual Obligation · Claim-Level Adjustment

Eligibility

What This Combination Means

The payer has denied the claim because the patient identification number (policy/member ID) and patient name submitted do not match their eligibility records. As a contractual obligation, the provider must write off the denied amount and cannot balance bill the patient, even though the error appears to be data-related rather than a coverage issue.

Financial Responsibility

provider writeoff

The provider is contractually obligated to write off the denied amount. The CO group code prohibits transferring this balance to the patient despite the mismatch being a correctable eligibility data error.

N/A

Appeal Success

7-14 days (corrected claim)

Avg. Resolution

Medium

Difficulty

No

Appealable

Step-by-Step Resolution

Steps tailored specifically to this CO-140 combination — not generic advice.

Not Appealable:CO denials for eligibility mismatches require corrected claim submission with accurate demographic data rather than appeal; the original claim cannot be reopened through appeal once the data discrepancy is identified.
  1. 1

    Verify patient demographics in practice management system

    Compare the health ID number and name exactly as they appear on the patient's insurance card and in the payer's eligibility system to identify the discrepancy

  2. 2

    Correct the demographic data error

    Update either the member ID number or patient name spelling to match the payer's records exactly, including suffixes, hyphens, and spacing

  3. 3

    Submit corrected claim with accurate matching information

    File as a corrected claim with frequency code 7, ensuring the health ID and name now align precisely with payer eligibility records to secure proper adjudication

Specialty Context

How CO-140 typically presents across different practice types.

Dental

Common when dependents are listed under subscriber's policy but name spelling or member ID suffix differs from family plan records

Medical

Frequently occurs with newly issued insurance cards, name changes due to marriage/divorce, or transposed digits in member ID entry

Behavioral Health

May occur when patients use preferred names during intake but insurance is under legal names, or when secondary insurance ID is entered instead of primary

Individual Code References

View the standalone definition for each code in this combination.

CARC 140

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Synthesized from official definitions — not from training data

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