Denial category

BCBS Documentation and attachment denials: Codes, Appeals and Fix Workflow

BCBS record request and attachment-required denial workflows with proof of submission and document packet indexing.

Category summary: Attach exactly what the RARC requests and connect it to the claim line with the claim number, patient, DOS, and document type.

Top codes in this category

CO-112Service not furnished directly to patient or not documented CO-148Information from another provider insufficient or incomplete CO-163Claim-referenced attachment or documentation not received CO-164Claim-referenced attachment not received timely CO-226Requested provider information not provided timely or complete CO-227Requested patient or insured information not provided CO-250Incorrect attachment or document received CO-251Attachment or documentation incomplete or deficient CO-252Attachment or documentation required to adjudicate claim

How to work these denials

Identify the document requested by the RARC, letter, or portal task.
Confirm the submission channel, attachment control number, and deadline.
Send an indexed packet with claim number, patient ID, DOS, provider, and line item clearly labeled.
If the payer says it never received the records, attach proof of submission and resubmit through the required channel.
If records were complete and timely, appeal with proof of receipt and a concise document map.

Evidence checklist

Requested records
Attachment control number
Proof of submission
Denial/RFI letter
Claim image
Document index

Guides in this cluster