What CO-109 means
The claim isn't payable by the payer or contractor it was sent to — often a routing problem (wrong plan, wrong MAC) rather than a coverage decision.
Common causes
- Claim sent to the wrong payer or plan
- Wrong Medicare Administrative Contractor jurisdiction
- Member moved to a different plan
How to appeal CO-109
Verify the correct payer/plan and jurisdiction, then resubmit to the right entity. Appeal only if the claim was correctly routed and still denied.
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Remitavo drafts a payer-specific CO-109appeal — citing the carrier's own policy — straight from your remittance file. Send a sample and we'll show you.
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