RCM Masters

Stop losing claims to the same denials

RCM Masters is a free community for US medical practices and billing teams. We break down the denials that cost practices the most, and show exactly how to prevent and fix them.

Remittance adviceClaim 4471-208
ServiceCPTAdj.Paid
Office visit99214CO-45$96.40
ECG, 12-lead93000CO-45$17.12
Echocardiogram93306CO-197$0.00
CO-197: authorization missing. The most expensive line on the claim, paid nothing.

CO-197

Precertification, authorization or notification absent.

What this denial means

The payer expected a prior authorization, precertification or notification for the service, and none was on file when the claim was processed. Because it's a contractual (CO) adjustment, the practice usually can't bill the patient for it.

How to prevent it

  1. Check authorization requirements when the service is scheduled, not at checkout.
  2. Record the authorization number where the biller will see it before the claim goes out.
  3. Recheck when the service changes: a different CPT code or date may need its own authorization.

How to fix it

If an authorization was obtained, correct the claim with the authorization number and resubmit. If it wasn't, ask the payer whether they accept a retro-authorization before deciding to appeal or write it off.

What you'll find at RCM Masters

Denial code breakdowns

What each common denial means, why it happens and what to do next.

Browse on rcmmasters.com

Short videos

Quick walk-throughs of denial codes your billing team can watch between claims.

Watch on YouTube

Practical guides

Coding, A/R follow-up and front-desk checks that keep claims clean.

Read the guides

Who's behind RCM Masters

RCM Masters is run by Balaji Pandian, CPC-A, who has spent more than 20 years in US healthcare revenue cycle management across Family Medicine, Nephrology, Cardiology, Psychiatry, Gastroenterology and OB/GYN.

The goal is simple: share what actually works in getting claims paid, in plain language, for the people who do the work.

Why you received an email from us

We write to medical practices and billing teams with practical revenue cycle tips. If you'd rather not hear from us, use the unsubscribe link at the bottom of any of our emails, or reply with the word "unsubscribe". Either way you're removed right away.

We don't sell or share email addresses. Questions? Write to balaji@rcmmasters.net.