291Denial Code (CARC)Active
CO 291 Denial Code: Forwarded to Dental Plan
CARC 291 indicates that the medical plan received the claim, but the benefits are not available under the patient's medical plan. Instead, the claim has been forwarded to the patient's dental plan for further review and processing.
Who Pays: Group Code Liability
For CARC 291, this adjustment typically falls under the CO group code, meaning it is a contractual write-off and cannot be billed to the patient. The provider should not expect payment from the patient for this portion of the claim.
Why Claims Get Code 291
- The patient's plan does not cover the service under their medical benefits but does under dental benefits.
- The service was mistakenly billed to the medical plan instead of the dental plan.
- The patient's coverage information was incorrectly captured, leading to submission to the wrong plan.
- The patient has dual coverage, and the primary medical plan does not cover the service, but the secondary dental plan might.
- The provider's billing system mistakenly categorized the service under medical instead of dental.
How to Fix & Resubmit
- Verify the patient's plan details to ensure the service is correctly categorized as a dental benefit.
- Check the forwarded claim status with the dental plan to confirm receipt and processing.
- Update the patient's insurance information in your system if there was a registration error.
- If the dental plan does not receive the claim, manually submit it to the correct plan.
- Contact the patient to verify any dual coverage details if necessary.
Corrected Claim or Appeal?
For CARC 291, a corrected claim is not applicable since the claim was forwarded. An appeal is not typically warranted unless the dental plan denies the forwarded claim.
Preventing Future 291 Denials
- Ensure accurate capture of patient insurance details during registration to prevent misrouting claims.
- Train staff to recognize services that should be billed to dental rather than medical plans.
- Regularly update your billing system to reflect the latest payer processing rules and plan details.
- Verify dual coverage details before claim submission to ensure correct routing.