AGAR Guide
CARC275ReferenceCurrentVerified Aug 15, 2026

CARC 275

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 prior payer's patient responsibility (deductible, coinsurance, copay) is not covered. Used with group code PR.

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

  • Secondary plan does not cover the primary's patient responsibility

AR Guide knowledge

What AR should verify

  1. Review the secondary plan's COB terms

AR Guide knowledge

Recommended action

  1. Bill the patient for the remaining patient responsibility per the 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.