How to appeal a Coordination of Benefits denial
A coordination-of-benefits (COB) denial means the payer believes another plan is primary, or the patient's COB information is out of date, so it won't pay until the order is resolved.
Common code: CARC 22 (may be covered by another payer)Why payers issue it
- The patient has a second plan and the primary/secondary order is unclear
- The member's COB record on file with the payer is outdated
- The primary payer's EOB wasn't attached to the secondary claim
- Eligibility or coverage dates overlap
What overturns it
- Submit the primary payer's EOB so the secondary can coordinate
- Help the patient update COB information with the payer
- Confirm and document the correct primary/secondary order
- Resubmit with the resolved COB details
Worth appealing? COB denials are usually a sequencing problem, not a coverage problem, once the order and the primary EOB are in place, the claim pays.
Common questions
How do I appeal a Coordination of Benefits denial?
A coordination-of-benefits (COB) denial means the payer believes another plan is primary, or the patient's COB information is out of date, so it won't pay until the order is resolved. To overturn it: submit the primary payer's EOB so the secondary can coordinate; help the patient update COB information with the payer; confirm and document the correct primary/secondary order; resubmit with the resolved COB details. The key is matching the documentation to the payer's own rule for coordination of benefits denials.
Is a Coordination of Benefits denial worth appealing?
COB denials are usually a sequencing problem, not a coverage problem, once the order and the primary EOB are in place, the claim pays. A no-risk recovery service makes it easy to find out, you only pay on what's actually recovered, so there's no cost to working the ones that are winnable.
How does Volari handle Coordination of Benefits denials?
Volari's AI agents identify coordination of benefits denials in your written-off pile, build each appeal with the right documentation and payer-specific argument, file it, and follow it to payment. You pay 25% only on what's recovered, and nothing if nothing comes back.
Volari's AI agentic crew that works your pile
The same AI agents that build and file your coordination of benefits appeals inside the app, each a specialist at one part of the fight, paid only on what they bring back.
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