Sent to the wrong insurer
The claim went to the wrong plan or Medicare contractor. The provider needs to send it to the right one.
Official meaning (X12 code 109): Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
Who pays
CO-109. Contractual obligation: the provider's contract with your plan makes this the provider's write-off. An in-network provider generally can't bill you for a CO amount.
What to do
- Give the provider your current insurance card.
- Ask them to bill the correct payer.
- Don't pay while it's rebilled.
If you appeal
The plan thinks another insurer should pay first. Usually a short call or form telling them you have no other coverage, or which plan is primary, reopens the claim.
Deadlines for the first appeal
- employer plan
- 180 days from the notice
- ACA Marketplace plan
- 180 days from the notice
- Medicare Advantage plan
- 65 days from the notice
- Original Medicare
- 120 days from the notice
- Medicaid
- 60 days from the notice
The date printed on your notice controls. Urgent care can be appealed on an expedited (72-hour) basis.
What the data show
Averages across all denials; not a prediction for yours.
Not sure this applies to you?
Paste the full reason from your notice into the free Denial Decoder for your deadline and rights.
General information, not legal or medical advice. Owed is a document-preparation and sending service, not a law firm.