How do I resolve a CO-276 denial?

Review the full denial on the 835 ERA for CARC 276: "Services denied by the prior payer(s) are not covered by this payer." Pull the original claim and all supporting documentation for the date of service. See full resolution steps at tryarceum.com.

Can I appeal a CO-276 denial?

Yes. Most CO-276 denials can be appealed within 60-180 days depending on payer. Appeals are appropriate if the primary payer's denial was incorrect or has been overturned, or if you can demonstrate the secondary payer has independent coverage obligations. Use our free tool to generate an appeal letter.

CARC Code

276

🔴 Hard Denial

Prior Payer Denial Not Covered

The primary insurance denied the claim, and the secondary insurance is stating they also will not cover these services. This payer only covers services when the primary payer approves them.

cob

Resolution: 85%Easy difficulty3-7 days avg

How to resolve this denial

Which payer denied this claim?

Review and resolve CARC 276: Services denied by the prior payer(s) are not covered by this payer.

1
Review the full denial on the 835 ERA for CARC 276: "Services denied by the prior payer(s) are not covered by this payer."
2
Pull the original claim and all supporting documentation for the date of service.
3
Identify the specific data element, policy requirement, or documentation gap that triggered this adjustment.
4
Correct the identified issue — update claim data, gather missing documentation, or verify coverage details.
5
Resubmit as a corrected claim (frequency type 7) or file a written appeal with supporting documentation.
6
Follow up with the payer within 10-15 business days to confirm adjudication.

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▶✓ 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-276 — stats, related codes, appeal template

85%

Recovery Rate

3-7 days

Avg. Resolution

Easy

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 276 by specialty.

General

Confirm payer-specific policy for CARC 276 and submit corrected claim or appeal as appropriate.

Appeal Letter Template

Generic appeal template for CARC 276 denials.

Dear [Payer Name] Appeals Department, We are writing to appeal the denial of claim [CLAIM #] for patient [PATIENT NAME] (Member ID: [ID]) for services rendered on [DATE OF SERVICE]. The claim was denied with CARC 276: "Services denied by the prior payer(s) are not covered by this payer." We believe this denial is in error for the following reasons: [INSERT CLINICAL/ADMINISTRATIVE JUSTIFICATION] We respectfully request reconsideration and payment of this claim. Sincerely, [Provider Name / Billing Contact]

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