CARCNon-Covered
CARC 139: Contracted/negotiated rate expired or not on file
The provider's contract with the insurer is outdated or missing, so the normal in-network rate doesn't apply.
What this means for your claim
Even if a provider has historically been in-network, if their contract lapsed or wasn't renewed, claims may process at out-of-network rates or be denied.
What to do next
- 1
Call your insurer to verify the provider's current network status as of your date of service.
- 2
If the provider was in-network when you scheduled (and the lapse happened after), file an appeal citing reasonable reliance.
- 3
Ask the provider to renegotiate or resolve the contract gap with the insurer directly.
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