CARC Code

237

🔵 Informational

Legislated or Regulatory Penalty Applied

The claim has been penalized due to a violation of a law or regulation. The payer is required to include additional remark codes explaining the specific reason for the penalty.

contractual
Resolution: 99%Medium difficulty1-3 days avg

How to resolve this denial

Review regulatory penalty basis; see RARC for specific regulation details

  1. 1

    Review the remittance advice to confirm the adjustment amount is accurate

  2. 2

    Verify the contractual write-off against your fee schedule

  3. 3

    Post the adjustment to the patient account

  4. 4

    Do not balance bill the patient for this contractual reduction

  5. 5

    Document the adjustment in your billing system

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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-237 — stats, related codes, appeal template

99%

Recovery Rate

1-3 days

Avg. Resolution

Medium

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 237 by specialty.

UnitedHealthcare

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

Appeal Letter Template

Generic appeal template for CARC 237 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 237 indicating: "Legislated/Regulatory Penalty.." 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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