308Denial Code (CARC)Active
CO 308 Denial Code - Contracted Funding Adjustment
Code 308 indicates that the payment adjustment is due to a contracted funding agreement between the payer and provider. This means the reduction in payment is based on a specific agreement or contract terms pre-negotiated with the payer.
Who Pays: Group Code Liability
With code 308, the adjustment typically falls under the CO group code, meaning it is a contractual write-off and the patient cannot be billed for this amount.
Why Claims Get Code 308
- The payer has a specific funding cap for services rendered, as outlined in the contract.
- The provider agreed to reduced reimbursement rates for certain services under a special funding agreement.
- The claim was processed under a bundled payment agreement, leading to lower individual service payments.
- There was a misunderstanding or misapplication of the contracted terms by the payer.
- The payer adjusted the payment due to a volume-based discount agreement.
How to Fix & Resubmit
- Review the contract terms with the payer to verify the adjustment is correct.
- Ensure the services billed match those covered under the contracted funding agreement.
- Contact the payer for clarification if the adjustment does not seem to align with the contract.
- If necessary, request a detailed explanation of how the adjustment was calculated.
- Document the findings and communicate any necessary changes to the billing team.
Corrected Claim or Appeal?
For code 308, submitting a corrected claim is not applicable. Instead, verify the contract terms. An appeal may be warranted if the payer misapplied the contracted agreement.
Preventing Future 308 Denials
- Regularly review and update contract terms with payers to ensure accurate billing.
- Train billing staff on the nuances of contracted funding agreements.
- Maintain a detailed record of all payer contracts for easy reference.
- Schedule periodic audits of claims processed under special funding agreements.