CARC 116: The advance indemnification notice signed by the patient did not comply with requirements.
The advance indemnification notice signed by the patient did not comply with requirements.
CARC 116 is the code your insurance company used to explain why your claim was reduced, denied, or paid less than expected. It appears on your Explanation of Benefits (EOB) — the statement your plan sends after a claim is processed. Here's what it means for you and what you can do about it.
What CARC 116 means
The official X12 description is: “The advance indemnification notice signed by the patient did not comply with requirements.”
In plain language: The advance indemnification notice signed by the patient did not comply with requirements.
What to do next 116
Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
DenialHelp helps organize a source-linked draft from the denial notice and confirmed case facts. The patient and treating clinician must verify the governing review rule, current payer policy, clinical sources, attachments, destination, and deadline.
CARC 116 group codes explained
On the 835 ERA, CARC 116 appears alongside a group code that signals who is financially responsible for the adjustment. CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
Frequently asked questions
What does CARC 116 mean?
The advance indemnification notice signed by the patient did not comply with requirements. In plain language: The advance indemnification notice signed by the patient did not comply with requirements.
Is CARC 116 appealable?
Yes — CARC 116 is one of the codes that commonly supports an appeal. Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
Which group code does CARC 116 appear under?
CARC 116 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
How do I appeal a CARC 116 denial?
Appeal with documentation specific to this code. The provider's billing office can help clarify what the carrier wants.
Related resources
Sources
Appeal a CARC 116 denial
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