CARC Code

156

🔵 Informational

Flexible spending account payments.

Resolution: 99%Easy difficulty1-3 days avg

How to resolve this denial

Accept FSA/HRA payment — applies to employer-sponsored flex benefit accounts

  1. 1

    Verify patient's cost-share obligation on the Explanation of Benefits

  2. 2

    Cross-reference with the patient's Summary of Benefits and Coverage

  3. 3

    Calculate the correct patient responsibility amount

  4. 4

    Issue a patient statement within 30 days of claim adjudication

  5. 5

    Document the patient balance in the account notes

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✓ Pre-action checklist — verify before contacting the payer
  1. Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.

  2. Verify the claim was submitted with correct patient eligibility and benefit information.

  3. Check if this denial applies to a specific line item or the entire claim.

More about PR-156 — stats, related codes, appeal template

99%

Recovery Rate

1-3 days

Avg. Resolution

Easy

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 156 by specialty.

UnitedHealthcare

Review UHC's online claim status tool for additional detail on this adjustment.

Appeal Letter Template

Generic appeal template for CARC 156 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 156 indicating: "Flexible benefit account payments.." 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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