OwedAppeal

Denial codes

CO-197

Denied for missing prior authorization

The plan required approval before this care, and its records show none. If the provider was in network, getting authorization was usually their job, and the CO group code means they generally can't bill you.

Official meaning (X12 code 197): Precertification/notification/authorization/pre-treatment absent.

Who pays

CO-197. 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

  1. Check the group code: CO-197 usually means the in-network provider absorbs it.
  2. Ask the provider to request retroactive authorization.
  3. If it was an emergency, say so: emergency care can't require prior authorization under federal law.
  4. Appeal with the medical records showing the care was needed.

If you appeal

If care was already given, your provider can usually request retroactive authorization. Emergency care never needs prior authorization under the ACA. If you had no way to know approval was needed, or your provider was responsible for getting it, say so: in-network providers often can't bill you for their own authorization failures.

What the appeal asks for: Approve this service retroactively. The care was medically necessary and, where applicable, emergency services cannot be subject to prior authorization.
Basis: 42 U.S.C. §300gg-111(a)(1) (no prior authorization for emergency services)

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

11.5%Only 11.5% of denied Medicare Advantage prior authorization requests were appealed in 2024. KFF, 2024 data
80.7%80.7% of appealed Medicare Advantage prior authorization denials were partially or fully overturned in 2024. KFF, 2024 data
<1% (262,982 appeals)Fewer than 1% of denied in-network marketplace claims were appealed in 2024 (at least 262,982 appeals). KFF, 2024 data
66% upheldInsurers upheld 66% of denials on internal appeal in 2024 (165,863 denials). KFF, 2024 data
9%9% of in-network marketplace denials were due to lack of prior authorization or referral. KFF, 2024 data

Averages across all denials; not a prediction for yours.

Appeal this denial

Upload your denial. We draft the appeal around this code, you approve it, and we fax it to your plan and mail a certified copy. Free check first, then $59.

Prepare my appealDecode my denial, free

General information, not legal or medical advice. Owed is a document-preparation and sending service, not a law firm.