AGAR Guide
CARC254ReferenceCurrentVerified Aug 15, 2026

CARC 254

AR Guide Workflow

Coordination of Benefits

Another plan may be primary, the primary's payment was not applied correctly, or the claim belongs with a different payer under COB rules.

Open denial workflow

AR Guide explanation

What it means

The claim was received by the dental plan but benefits are not available under it. Submit the services to the patient's medical plan.

AR Guide knowledge

Common denial category

Coordination of Benefits — Another plan may be primary, the primary's payment was not applied correctly, or the claim belongs with a different payer under COB rules.

AR Guide knowledge

Common causes

  • Service billed to the wrong plan type
  • Dental plan does not cover the service

AR Guide knowledge

What AR should verify

  1. Confirm the service belongs under the medical benefit

AR Guide knowledge

Recommended action

  1. Submit to the correct medical plan

About this guidance: Note

AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.