BillingSolutions

Denial code N115 occurs when a service or item is not deemed medically necessary based on a Local Coverage Determination (LCD) or Local Medical Review Policy (LMRP). These denials can lead to lost reimbursements, delayed payments, and administrative burdens for healthcare providers, billing teams, and practice managers. By understanding why N115 denials happen and implementing

Denial codes CO242 and CO243 occur when a service is not authorized by the network or primary care provider (PCP). These denials impact cash flow, delay reimbursements, and increase administrative burdens. For practice managers, healthcare providers, and billing teams, understanding the root causes of these denials and applying preventative strategies is essential for reducing claim

Denial code 96 is issued when a billed service, procedure, or item is not covered under a patient’s insurance plan. These denials can result from policy exclusions, incorrect coding, or lack of pre-authorization, leading to payment delays and lost revenue for healthcare providers. For practice managers, billing teams, and healthcare providers, understanding the root causes