Where it shows up on the ERA
- CARC 197No prior authorization.
- CARC 16Missing / invalid information.
- CARC 29Timely filing exceeded.
A denial is data. We classify, prioritize, appeal, and — most importantly — fix the upstream workflow so the same code doesn't appear next month.
Specialists for high-cost denials: 197 (prior auth), 16 (missing info), 29 (timely filing), 97 (bundling).