143Denial Code (CARC)Active
OA 143 Denial Code - Resolve Deferred Payments
Code 143 means that a portion of the payment for the claim has been deferred. This doesn't necessarily indicate a denial, but rather that the payer has held back part of the payment for future processing or consideration.
Who Pays: Group Code Liability
For code 143, the group code is OA. This means that the deferred payment is a temporary adjustment by the payer, and the patient cannot be billed for this portion.
Why Claims Get Code 143
- The payer is conducting a review or audit on the claim.
- The payer is awaiting additional information or documentation before releasing full payment.
- A portion of the claim is under coordination of benefits review with another payer.
- The payer's processing system flagged the claim for further examination.
How to Fix & Resubmit
- Contact the payer to determine the specific reason for the deferral under code 143.
- If additional information or documentation is required, gather and submit it promptly to the payer.
- Monitor the claim status regularly to ensure that the deferred payment is released once the issue is resolved.
- If the deferral is due to a coordination of benefits review, verify that the primary payer’s information is correct and up-to-date.
Corrected Claim or Appeal?
For code 143, a formal appeal is generally not necessary. Instead, focus on providing any requested information to the payer to facilitate the release of the deferred payment.
Preventing Future 143 Denials
- Ensure all required documentation is submitted with the initial claim to prevent deferrals.
- Regularly verify coordination of benefits information to avoid unnecessary reviews.
- Establish a process to quickly respond to payer requests for additional information.
- Maintain clear communication channels with payers to expedite resolution of any issues.