Explore practical Accounts Receivable (AR) scenarios used in medical billing, including common claim issues, denial cases, and real-world resolution steps to help improve AR workflow and billing knowledge.
- No Claim On File
- Claim in Process
- Approved to Pay
- Claim Paid Not Received
- Claim Paid Offset Explained
- Claim paid to patient
- Deductible in Insurance Explained
- Claim denied as patient cannot be identified
- Claim denied as Coverage Terminated
- Claim denied as the time limit for filing has expired
- Claim denied as authorization absent or missing
- Claim denied as referral is absent or missing
- Claim denied as maximum benefit exhausted – reached
- Claim denied as non covered charges
- Claim denied as non covered charges as provider is out of network
- Claim denied as additional information requested from patient
- Claim denied as additional information requested from provider
- Claim denied as medical records requested
- Claim denied as Duplicate
- Claim denied as patient enrolled in hospice
- Claim denied as procedure code inconsistent with the modifier used
- Claim denied for invalid modifier on date of service
- Claim denied as diagnosis code is inconsistent with the procedure
- Claim denied as diagnosis code is invalid for date of service
- Claim denied as Procedure code was invalid on the date of service
- Claim denied as referring provider is not eligible to refer the service billed
- Claim denied for primary EOB
- Claim denied as other payer is primary
- Claim denied as Secondary payment cannot be considered without the identity of or payment information from the primary payer
- Claim denied as claim not covered by this payer
- Claim paid directly to provider under Capitation contract (or) Claim denied as patient covered under capitation or managed care plan
- Claim denied for invalid place of service
- Claim denied as primary paid more than secondary allowed amount
- Claim denied as medically not necessity
- Claim denied as This is a work-related injury (or) illness and thus the liability of the Worker’s Compensation Carrier
- Claim denied as This injury (or) illness is covered by the liability carrier
- Claim denied as This injury (or) illness is the liability of the no-fault carrier (or) Auto insurance
- Claim denied as Bundle (or) Inclusive
- Claim denied as Globally inclusive to Surgery
- Claim denied as procedure combination is not compatible with another procedure
- Claim denied as procedure code is not paid separately
- Claim denied as rendering provider is not eligible to perform the service billed
- Claim denied as the procedure code is inconsistent with provider type (or) specialty
- Claim denied as routine services not covered
- Claim denied as This provider was not certified (or) eligible to be paid for this procedure (or) service on this date of service
- Pre-Existing Condition Denials in Health Insurance: A Complete Beginner’s Guide
- Procedure Code Inconsistent with Patient’s Gender: A Complete Guide for Medical Billing Professionals
- Procedure Code Inconsistent with Patient’s Age: A Complete Guide to Handling Denials
- Procedure Code Inconsistent with Patient’s Age: Complete Guide to Handling This Denial
- Diagnosis Code Inconsistent with Patient’s Age: How to Handle This Denial Effectively
- M119 Denial Explained: Missing, Invalid, or Incomplete NDC Code (Beginner-Friendly Guide)
- MA120 Denial: Missing, Incomplete, or Invalid CLIA Certification Number — A Complete Guide
- New Patient vs Established Patient Codes (E/M Coding Guide for Beginners)
- How to Resolve Denial Code 129: “Prior Processing Information Appears Incorrect”
- Understanding Denial Code 151 in Medical Billing: A Beginner-Friendly Guide
- 13: The Date of Death Precedes the Date of Service: A Complete Guide for Medical Billing Professionals
- Procedure/Treatment/Drug Denied as Experimental or Investigational: Complete Guide for Medical Billing Teams
- Denial Code 55: Procedure/Treatment/Drug Deemed Experimental or Investigational
- Revenue Code and Procedure Code Do Not Match (Denial Code 199): A Complete Beginner’s Guide
- How to Work on Denial Code 45 (CO-45 & PR-45): A Beginner-Friendly Guide
- Denial Code 150: “Payer Deems the Information Submitted Does Not Support This Level of Service”
- B20 Denial Code: Procedure/Service Furnished by Another Provider — Complete Guide
