How do I resolve a CO-116 denial?

Pull the original claim and review the denial reason and any RARC codes Research the payer's policy for CARC 116 to understand the basis for denial See full resolution steps at tryarceum.com.

Can I appeal a CO-116 denial?

Yes. Most CO-116 denials can be appealed within 60-180 days depending on payer. This is appealable if you can provide a corrected or compliant indemnification notice, or demonstrate that the original notice did meet all requirements. Use our free tool to generate an appeal letter.

CARC Code

116

🔴 Hard Denial

Noncompliant Advance Indemnification Notice

The form the patient signed promising to pay if insurance doesn't cover the service was filled out incorrectly or didn't meet the payer's specific requirements. The claim is being denied because the advance notice paperwork was defective.

missing info

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

Obtain a compliant ABN signature and resubmit with correct notice

1
Pull the original claim and review the denial reason and any RARC codes
2
Research the payer's policy for CARC 116 to understand the basis for denial
3
Gather supporting documentation addressing the denial reason
4
Submit a formal appeal with the documentation within the plan's appeal window
5
Follow up on the appeal within 30 days and document all communication

Resolve this denial →

▶✓ Pre-action checklist — verify before contacting the payer

Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.

▶More about CO-116 — stats, related codes, appeal template

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 116 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Appeal Letter Template

Generic appeal template for CARC 116 denials.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 116 indicating: "The advance indemnification notice signed by the patient did not comply with req." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

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