CARC Code
184
Provider Not Eligible to Prescribe/Order
The claim was denied because the provider who prescribed or ordered the service does not have the proper credentials or authorization to do so. The payer has determined this provider is not qualified to prescribe or order the specific service that was billed.
authorizationHow to resolve this denial
Verify prescribing provider credentials and enrollment status; obtain order from eligible provider
- 1
Verify the rendering or referring provider's enrollment status with this payer
- 2
Check that the provider's NPI, taxonomy, and license are current and active
- 3
If the provider is not enrolled, initiate enrollment before resubmitting
- 4
Obtain a re-referral or re-order from an enrolled, eligible provider if needed
- 5
Resubmit the claim with the correct enrolled provider information
▶✓ 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-184 — stats, related codes, appeal template
35%
Recovery Rate
21-45 days
Avg. Resolution
Hard
Difficulty
Occasional
Frequency
Payer-Specific Notes
How major payers handle CARC 184 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Appeal Letter Template
Generic appeal template for CARC 184 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 184 indicating: "The prescribing/ordering provider is not eligible to prescribe/order the service." 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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