In the healthcare industry, claim denials are a frequent challenge that can impact revenue cycles and disrupt patient care. One of the most commonly encountered denial codes is CO 24, which signals an issue related to charges covered under a capitation agreement or managed care plan. Understanding the intricacies of this denial code is crucial for healthcare providers, as it allows them to respond effectively, minimize payment delays, and maintain a smooth billing process. The CO 24 denial code stands for "Charges are covered under a capitation agreement/managed care plan." This denial occurs when the insurance payer determines that the services provided to the patient are covered under a capitated payment model or a managed care plan, meaning no additional payment is due to the provider for that service.
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