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211
CO - Contractual ObligationCoverage
Denial Code CO-211: Benefit Not Provided - Plan/Network
What Does Code 211 Mean?
Payment adjusted because the service is provided by a plan/network provider, but benefits are not available for this particular service.
Group Code CO (Contractual Obligation): The provider has agreed to accept the payer's determination. The patient is generally not responsible for this amount.
Why Does This Happen?
In-network provider but the specific service is carved out or not covered.
How to Resolve It
- 1Verify the benefit carve-out with the payer
- 2Check if the service should be billed to a different entity
- 3Inform the patient of non-covered services
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