Key Takeaways: CO 45 = “Charge exceeds fee schedule/maximum allowable or contracted rate.” It usually represents a contractual adjustment, not a billable patient balance. Common causes include outdated fee schedules, incorrect coding, or missing modifiers. Prevention requires accurate contract management, claim scrubbing, and staff training. Partnering with Allzone helps healthcare providers streamline denial management and […]
The Prime Minister’s recent voluntary national survey shed light on the Denied claims. The survey, conducted between October and December 2023, found that nearly 15% of all Medicare Advantage, Medicaid, Commercial and Managed Medicaid claims were denied. Between 45% and 60% of rejected cases were overturned, although the expensive appeals process sometimes meant multiple appeals. […]


