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Updated as of October 2, 2025
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We strongly recommend reducing all edit remark codes to this, which will act as a pointer to the Provider to see the exact detailed edits, reasoning, and supporting documentation or evidence.
| Goodbill Service | When to Apply | Type | Code | Standard Remark | Custom EOB Remark | Accompanying RARC (if applicable) | Standard RARC Remark |
|---|---|---|---|---|---|---|---|
| Claim Review | For any present edits | Proprietary | GBE | GBE: Claim reduced and paid in accordance with itemized bill review findings. See detailed findings at goodbill.com/status. | N842 | Patient cannot be billed for charges. |
| Goodbill Service | When to Apply | Type | Code | Standard Remark | Custom EOB Remark | Accompanying RARC (if applicable) | Standard RARC Remark |
|---|---|---|---|---|---|---|---|
| **501(r) | |||||||
| (New - recommended)** | Denial upon Application Submitted (Recommended) | CARC | 16 | Claim/service lacks information or has submission/billing error(s). | Information was requested from the Billing/Rendering Provider and was not provided, or not provided timely, or was insufficient/incomplete. |
| | 501(r) | Denial upon Application Submitted | CARC | PR22 | This care may be covered by another payer per coordination of benefits. | Claim denied. This plan is secondary to other discounts or coverage that may be available. | | | | 501(r) | When repricing to AGB | CARC | 96 | Non-covered charges. | Hospital discount applied per your plan benefits; you are not responsible for charges above this amount. | N130, N578, M41, MA02 | Consult plan benefit documents/guidelines for information about restrictions for this service.
Coverages do not apply to this loss.
We do not pay for this as the patient has no legal obligation to pay for this.
Alert: If you do not agree with this determination, you have the right to appeal. You must file a written request for an appeal within 90 days of the date you receive this notice. | | 501(r) | When repricing to AGB | CARC | 45 | Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. | Hospital discount applied per your plan benefits; you are not responsible for charges above this amount. | N130, N578, M41, MA02 | Consult plan benefit documents/guidelines for information about restrictions for this service.
Coverages do not apply to this loss.
We do not pay for this as the patient has no legal obligation to pay for this.
Alert: If you do not agree with this determination, you have the right to appeal. You must file a written request for an appeal within 180 days of the date you receive this notice. | | | | | | | | | |