Glossary
BCBS Denial Code Glossary
Plain-language glossary for BCBS denial code work: CARC, RARC, group codes, 835 ERA, corrected claims, appeals, COB and BlueCard.
CARC
Claim Adjustment Reason Code. It explains why payment was adjusted.
RARC
Remittance Advice Remark Code. It gives additional detail or informational messaging.
Group code
Adjustment group code such as CO, PR, OA or PI that helps identify responsibility.
Corrected claim
A revised claim submitted with corrected data according to payer rules.
Appeal
A request for review of a denial or adverse decision, usually with evidence.
BlueCard
A BCBS program used for out-of-area members and local Blue plan claim handling.
COB
Coordination of Benefits. It determines payer order when more than one payer may cover a claim.
835 ERA
Electronic Remittance Advice transaction used to report payment and denial details.