CO 24 Denial Code-Charges are covered under a capitation agreement

Are you aware of the times when the claims were denied by medical insurance authorities? The co 24 denial code is one such code that has caused ample confusion already.

There may be a number of questions coming to your mind about the Denial Code CO 24 and thus to clear the same, here we have come up with some relevant information on the same.

What is CO 24 Denial Code?

If any patient is already covered under the Medicare advantage plan but in spite of that the claims are submitted to the insurance, then the claims which have been denied can be stated by the CO 24 denial code.

CO 24 – Charges are covered under a capitation agreement or managed care plan

In other words, it can be stated that the charges which are maintained under the capitation agreement, are managed under the medicare plan, and in case of any further occurrence of the same- would make the claim get declined by the CO24 Denial Code.

Moreover, these Medicare advantage plans are typically offered by private insurance service providers, which are examined thoroughly and then get reimbursed for the patient. Hence, there is no chance of skipping the thorough scan for any claims.

How can the CO 24 Denial Code be resolved?

The steps are listed below that you must follow to resolve the CO24 denial code.

  • Verify the type of Medicare Plan

In the first step, make sure to verify the type of Medicare insurance plan the patient has been covered with- it could either be primary or secondary.

  • Update Insurance

Keep the insurance information updated after the verification has been done.

  • Contact COB

Thereafter, contact the COB for the re-verification process to take place, or even the patients themselves get the privilege to continue with the verification process.

  • Denial

In case the denial took place because the medicare plan was selected as the secondary payer, move on to submit the claim to the primary one. And that’s all about it!

How can one get rid of the CO24 Denial Code?

Wondering how to get rid of the co24 denial code? Well, then here is a list of the things which you could take care of. 

  • Check the eligibility

First, make sure to check the eligibility of the medicare insurance plan to know if the patient would benefit from it or not.

  • Obtain the membership ID

After this, obtain the membership ID of the insurance account holder. This can be obtained from the policymaker as well as from the patient as well.

  • Submit the care plan

Lastly, submit the care plan to the private insurance company to get rid of the Denial CO- 24.

Frequently Asked Questions-FAQs

Q1. How to address the revenue loss if any?

Ans. In case you find out that there has been a denial because medicare was a secondary payer, then you may have to select to submit the claim to the primary payer. Doing this would help to address the revenue loss if something took place already.

Q2. What can you do if the Denial Code CO 24 has already arrived?

Ans. If you have already received the denial code CO 24, then start with consulting with the Medicare Insurance department authorities.
Ask them questions including the received code and denied date of the claim, details about the managed care insurance, call reference, and the claim number.

Q3. How can you prevent the CO 24 Denials?

Ans. If you want to prevent the CO 24 denial code, then simply start with finding out if the patient has coverage under the care plan or not.
After that, try to get the detailed information including the member ID from the patient which can be followed by the submission of the claims once again, the right way.

What is Denials Management in Medical Billing? List of Denial Codes

 

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  • NSingh (MBA, RCM Expert)

    The author and contributor of this blog "NSingh" is working in Medical Billing and Coding since 2010. He is MBA in marketing and Having vaste experience in different scopes of Medical Billing and Coding as AR-Follow-up, Payment Posting, Charge posting, Coding, etc.