Free tool · no sign-up

Which denials to work first

Not the biggest balances — the most tractable ones. Put your dollars against the codes and this sorts them by what kind of problem each denial actually is.

Put the dollar value you are holding against each code. Leave the rest blank. Nothing is sent anywhere.

CO-197 Prior authorization absent

CO-16 Claim lacks information or has a submission error

CO-29 Time limit for filing has expired

CO-45 Charge exceeds the fee schedule

CO-22 May be covered by another payer

CO-27 Expenses incurred after coverage terminated

CO-50 Not deemed medically necessary

CO-97 Included in the payment for another service

CO-B7 Provider not certified or eligible on this date

CO-11 Diagnosis inconsistent with the procedure

CO-109 Not covered by this payer or contractor

CO-151 Information does not support this many services

PR-204 Not covered under the patient’s current plan

CO-4 Procedure code inconsistent with the modifier

CO-96 Non-covered charges

CO-18 Exact duplicate claim or service

Why sorting by dollars is the wrong instinct

Every aged AR report sorts by balance, so that is how the pile gets worked. It is almost always wrong. A single large clinical-judgement denial can absorb an hour and lose, because the documentation either supports the level or it does not and no amount of calling changes that. Twenty clerical denials can absorb the same hour and mostly pay, because nothing about them is in dispute.

The order that works is by kind of problem first and dollars second. That is not a clever insight — every experienced AR caller does it instinctively. What they rarely have is the whole pile sorted that way in front of them at the start of the week.

Questions

Which denials should I work first?

Clerical denials first — the claim was substantively fine and a field was wrong, so a corrected claim usually pays and one person can clear a lot in a day. Then information the payer asked for and did not get. Contractual adjustments last, because they are not money at all and chasing them is wasted labour.

Should I work the biggest balances first?

Not on their own. A large clinical-judgement denial can take an hour and lose; twenty clerical denials can take an hour and mostly pay. Sort by the kind of problem first, then by dollars inside each kind — which is what this tool does.

Are timely filing denials worth working?

Only where you can produce proof the claim arrived on time — the clearinghouse acknowledgement, not a note in your practice management system. With that proof they reverse routinely. Without it the pile is a write-off, and working it is labour spent on nothing.

Why does this not show a recovery percentage?

Because we would be inventing it. We have no audited outcome data by denial code across a client base, and a percentage on a page like this becomes the most-quoted number on it. What is knowable is the nature of each code, which is a fact about the code rather than a prediction about your practice.

Written by Ibtesam Asif · Last reviewed 2026-09-10

This is written from our own operational experience rather than from a survey or a dataset. Where a figure comes from somebody else, it is cited beside the figure.

Other free tools

Next step

Somebody to actually work the list

An AR caller who starts at the top of it, full time, in your system, from $1,700 a month.

Book a 20 minute call See the prices

Or write to ops@softhomeglobal.com