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Denials and appeals blog
Working denials to the cause: codes, appeal routes and the front-end fixes that stop them.
10 posts, newest first, from the Remitwright medical billing blog. Each one works through a hypothetical example and lists its sources.
Posts in Denials and appeals
- Denials and appealsHow to write a claim appeal letter a payer will actually readFew denials are appealed, yet MA plans overturned most appealed prior auth denials in 2024. How to write a claim appeal letter and the packet behind it.Updated Read
- Denials and appealsThe Medicare 60-day overpayment rule: when the clock starts and how to refundThe Medicare 60-day overpayment rule in 42 CFR 401.305: when the clock starts, how a timely investigation suspends it, and how to report and return money.Updated Read
- Denials and appealsHow to appeal a Medicare Part B denial: the five levels and their deadlinesMedicare Part B appeal deadlines run from the remittance for a redetermination, then from each decision after it. The five appeal levels and what to send.Updated Read
- Denials and appealsThe denial reasons practices report most in 2026, and the front-end fix for eachDenials are the top revenue leak for nearly half of medical groups, MGMA found in January 2026. The reasons, the benchmark rate and a fix for each.Updated Read
- Denials and appealsTimely filing when the payer or broker changes mid-yearBrokers, MCOs and clearinghouses change; filing limits do not pause. How timely filing after a payer transition works for Medicare, Medicaid and brokers.Updated Read
- Denials and appealsEligibility denials are about to climb: six-month Medicaid renewals and work requirements from 2027Work requirements and six-month Medicaid renewals arrive by January 2027. Why eligibility denials rise, which codes follow and the check that stops them.Updated Read
- Denials and appealsSecondary claims and COB denials: CO-22, MA04 and the order of operationsSecondary claim denials trace to the order of operations: who is primary, what the crossover sent, and whether the claim balances. CO-22 and MA04 decoded.Updated Read
- Denials and appealsWhat a 277CA rejection means, and why it never shows up on the ERAA 277CA tells you whether the payer's front end accepted your 837 or rejected it. Rejected claims never reach the 835, and the filing clock keeps running.Read
- Denials and appealsHow to check the Medicare Coverage Database before you bill a serviceThe Medicare Coverage Database holds every NCD, LCD and billing article. A lookup by code and state that prevents CO-50 denials before you bill.Read
- Denials and appealsReading CARC and RARC codes together: why the pair mattersCARC and RARC codes explained as a pair: why the group code matters, which CARCs need a remark code, the common pairs and how each pair routes the fix.Read