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Denial Code 278

CARC 278: Performance program proficiency requirements not met

This is a Claim Adjustment Reason Code (CARC). CARCs explain why a payer adjusted or denied a claim line and appear with a group code (CO, PR, OA, PI). Codes appear on the EOB / ERA after a claim is adjudicated.

Reference only — CARC/RARC are national code sets updated periodically. Verify against the current official list before acting on a denial or appeal.

Related CARC codes

275
Prior payer's patient responsibility not covered
276
Services denied by the prior payer(s) are not covered by this payer
277
The disposition of the claim/service is undetermined during the premium payment grace peri…
279
Services not provided by Preferred network providers
280
Claim received by the medical plan, but benefits not available under this plan. Submit the…
281
Deductible waived per contractual agreement. Use only with Group Code CO

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