CARC Code

226

🟡 Soft Denial

Missing or Incomplete Provider Information

The insurance company asked for additional information from your provider, but it was either not sent, sent too late, or was incomplete. The claim cannot be processed until the requested information is received.

missing info
Resolution: 82%Medium difficulty7-14 days avg

How to resolve this denial

Submit requested information with appeal; check RARC for specific missing document

  1. 1

    Review the RARC code to identify the specific document(s) required

  2. 2

    Gather the required documentation from the provider or medical records department

  3. 3

    Submit the documentation through the payer's electronic attachment portal or fax

  4. 4

    Resubmit the claim with the attachment reference number if required

  5. 5

    Confirm receipt and track to adjudication

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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 CO-226 — stats, related codes, appeal template

82%

Recovery Rate

7-14 days

Avg. Resolution

Medium

Difficulty

Common

Frequency

Payer-Specific Notes

How major payers handle CARC 226 by specialty.

UnitedHealthcare

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

Common 835 Combinations

CARC 226 most often appears with these Group Code + RARC combinations on 835 remittances.

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 226 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 226 indicating: "Information requested from Billing/Rendering Provider was not provided or was in." 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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