CARC 152: Payer deems the information submitted does not support this length of service
Your insurer says the records don't justify how long the service or stay lasted.
What this means for your claim
This commonly applies to time-based services (like extended infusions or prolonged visits) or inpatient stays where the insurer believes a shorter duration was appropriate. The disputed portion may shift to you.
What to do next
- 1
Ask your provider to submit documentation supporting the full duration of the service or stay.
- 2
If an inpatient stay was reduced, ask whether a peer-to-peer review or level-of-care appeal can be filed.
- 3
File an appeal with clinical notes showing why the full length of service was medically necessary.
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