Paste denial codes. See the likely root-cause pattern in minutes.
Paste CARC or RARC codes. Browser-local analysis groups them by the operational lane most likely to need attention.
What does this tool do?
It reads denial codes, groups them into the most likely operational cause, and gives a fix-it summary for the next review step. It does not ask for patient context, and it does not replace a claim-level appeal decision.
Start with the codes you already have.
The value shows up before any protected workflow starts. If the pattern points to a larger operational issue, move to a live case review after the diagnostic.
What you get
- 01
Paste codes only
Drop in CARC or RARC denial codes from an ERA, work queue, or portal export.
- 02
See grouped causes
The tool clusters the codes into the operational lane most likely driving the batch.
- 03
Stay PHI-free
No names, IDs, dates, or notes. Analysis stays in this browser and the paste is not uploaded.
Sample code list
CO-197 197 50 97 16 29
What this diagnostic reads, and what it will not accept.
Reads denial codes
Paste CARC or RARC codes from an ERA, portal, or work queue export. The grouping logic is educational and rooted in real denial-code categories.
Rejects likely PHI
Names, long IDs, dates, and free-text notes do not belong here. A browser-local tripwire flags common patient-detail patterns, and the paste is never uploaded.
Orients the next review
Use the grouping to sequence the next review lane. Then move to claim-level context only inside a protected workflow.
Most patterns here trace back to a prior authorization requirement.
A denial pattern is often the downstream sign of a payer requirement that shifted, or a case that went out with a gap the payer was always going to flag. The prior authorization case workbench reads for that friction before a case is submitted, so a pattern like this one has a chance to be caught earlier next time.
See the case workbench in the full loopPlain answers about the diagnostic.
- Is this diagnostic free, and does it require patient data?
- Yes, it is free, and it does not require or upload patient data. Paste only CARC or RARC codes: no names, member IDs, dates, or free-text notes.
- What does the diagnostic actually do?
- It groups the codes you paste into the most likely operational root cause and gives a fix-it summary for the next review step. It is educational: it does not replace a claim-level appeal decision.
- How does this connect to prior authorization?
- Many denial patterns trace back to a prior authorization requirement that shifted or was missed. The case workbench reads for that payer friction before a case is submitted, so the pattern this diagnostic surfaces has a chance to be caught earlier next time.
- What happens after I see my pattern?
- Bring a live batch to a case review. That conversation happens inside a protected workflow, with the same guardrails, not on this public page.
Bring a live batch.
We will walk through your codes inside a protected workflow, with the same guardrails, and show where the case workbench would have caught the pattern earlier.