CARC 23: The impact of prior payer(s) adjudication including payments and/or adjustments
The payment reflects what's left after another insurer already paid part of this claim.
What this means for your claim
When you have two insurers, the secondary payer processes the claim based on what the primary already paid. This code shows the secondary payer's calculation of the remaining balance.
What to do next
- 1
Compare the primary and secondary EOBs side by side to verify the secondary payer calculated the balance correctly.
- 2
If the secondary payer's payment seems too low, confirm they received the primary EOB with all payment details.
- 3
Contact your secondary insurer if any portion of the remaining patient balance should have been covered.
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