CARC Code
3
Co-payment Amount
The patient is responsible for a co-payment amount as defined by their insurance plan. This is a fixed fee the patient must pay for the service received.
patient responsibilityHow to resolve this denial
Collect co-payment from patient at time of service or bill patient
- 1
Verify the copay amount from the patient's insurance card or eligibility check
- 2
Confirm copay was collected at time of service
- 3
If not collected, issue patient statement for copay amount
- 4
Do not balance bill beyond the stated copay amount
- 5
Document copay collection in patient account notes
▶✓ 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 PR-3 — stats, related codes, appeal template
98%
Recovery Rate
1-2 days
Avg. Resolution
Easy
Difficulty
Very Common
Frequency
Payer-Specific Notes
How major payers handle CARC 3 by specialty.
UnitedHealthcare
Specialist copay is typically higher than PCP copay; verify tier
Humana
Urgent care copay differs from ER and specialist — confirm visit type
Common 835 Combinations
CARC 3 most often appears with these Group Code + RARC combinations on 835 remittances.
Appeal Letter Template
Generic appeal template for CARC 3 denials.
Please remit the patient co-payment of $[AMOUNT] for services rendered on [DOS] per claim [CLAIM_NUMBER]. This co-payment reflects the standard [SPECIALTY] visit copay under the patient's [PLAN_NAME] plan.
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