CARC 3 - Co-payment Amount

What it means

This part of the charge was applied to the patient's co-payment responsibility under their insurance plan. It is not a denial of the service, but a notice that the patient owes this fixed amount per the plan's benefit structure.

Common causes

• The patient's insurance plan requires a fixed co-payment for the type of visit or service billed
• The co-payment amount was not collected at the time of service
• The claim was processed correctly, and the payer is identifying the patient-owed portion
• Incorrect co-payment amount applied due to outdated plan benefit information

How to fix it

1. Verify the co-payment amount on the remittance advice matches the patient's current plan benefits
2. Confirm whether the co-payment was already collected at the time of service to avoid double billing
3. If not collected, bill the patient for the co-payment amount shown
4. Check eligibility and benefits verification tools to confirm the correct co-pay for future visits
5. If the amount seems incorrect, contact the payer to confirm the patient's benefit plan details

Appeal / resubmit

This code typically is not appealable since it reflects a standard patient responsibility amount rather than a payer denial. However, if you believe the co-payment amount applied is incorrect (e.g., wrong plan tier, wrong visit type), contact the payer to review the benefit application and request a corrected remittance if an error is confirmed.

Related codes

• 1
• 2

Frequently asked

More free billing tools: all denial codes · denial lookup · Medicare fee calculator

This content is for informational purposes only and does not constitute billing or legal advice. Always verify current payer policies and consult a qualified billing professional for specific cases.