302Denial Code (CARC)Active
CO 302 Denial Code - Fix Expired Authorization Issues
Code 302 indicates that the precertification, notification, authorization, or pre-treatment time limit required by the payer has expired. This means the claim was submitted after the allowed timeframe, leading to a denial or reduction in payment.
Who Pays: Group Code Liability
The group code for code 302 is typically CO, meaning this is a contractual obligation and the provider must write off the amount. Patients cannot be billed for this amount.
Why Claims Get Code 302
- The claim was submitted after the payer's deadline for precertification or authorization.
- The provider did not obtain the required authorization within the specified timeframe.
- The notification to the payer about the treatment was delayed beyond the allowed period.
- The pre-treatment time limit set by the payer was not met.
How to Fix & Resubmit
- Verify the payer's specific precertification or authorization time limits for the service in question.
- Check if the authorization was obtained within the required timeframe and if any documentation can prove it.
- If the authorization was timely but the claim was delayed, gather documentation to support an appeal.
- Contact the payer to discuss any possible exceptions or reconsideration if the delay was due to extenuating circumstances.
Corrected Claim or Appeal?
A formal appeal is warranted if you can prove the authorization or notification was obtained within the correct timeframe. If this proof is unavailable, the adjustment stands as a contractual obligation.
Preventing Future 302 Denials
- Set reminders for obtaining authorizations well before the payer's deadline.
- Implement a system to track and manage precertification and authorization deadlines.
- Educate staff on the importance of timely notifications to payers.
- Regularly review payer contracts for updates on precertification requirements.