835 Denial Combination
CO-195+N14
Contractual Obligation · Claim-Level Adjustment
Contractual ObligationWhat This Combination Means
A refund has been issued to a payer that was incorrectly listed as primary for this claim, and any payment adjustment is governed by contractual fee schedules or allowable amounts. This combination indicates coordination of benefits correction where the wrong payer was billed first, and the contractual relationship determines how the recoupment or adjustment is calculated.
Financial Responsibility
reversal
The payer has reversed payment previously made to the wrong primary payer, with adjustment amounts determined by contractual fee schedules. This represents a claim reprocessing due to incorrect payer sequencing.
N/A
Appeal Success
30-60 days (coordination of benefits correction)
Avg. Resolution
Medium
Difficulty
No
Appealable
Step-by-Step Resolution
Steps tailored specifically to this CO-195+N14 combination — not generic advice.
- 1
Verify correct payer hierarchy using patient's current coverage information
Confirm which payer should be primary, secondary, or tertiary to prevent future erroneous priority billing
- 2
Rebill the correct primary payer with accurate coordination of benefits information
Submit claim to the actual primary payer since the erroneous payer has issued a refund and will not process as primary
- 3
After primary payer adjudication, bill secondary payer with primary EOB attached
Ensure proper claim sequencing to recover full contractual reimbursement according to each payer's fee schedule
Specialty Context
How CO-195+N14 typically presents across different practice types.
Dental
Common when medical insurance was billed before dental-specific coverage, or when coordination between medical and dental plans requires refund from incorrect primary
Medical
Frequently occurs with Medicare/Medicaid coordination errors, auto/workers' comp priority issues, or when dependent/subscriber coverage hierarchy is reversed
Behavioral Health
May arise when behavioral health carve-out plans are incorrectly sequenced with medical plans, or when EAP benefits should have been billed before insurance
Individual Code References
View the standalone definition for each code in this combination.
Need to resolve this denial?
Get a complete resolution plan with appeal guidance for this exact combination in seconds.
Generate a free resolution plan & appeal letter →Synthesized from official definitions — not from training data