Denied: another insurer may be primary
The plan thinks you have other coverage that should pay first. Often its records are just out of date.
Official meaning (X12 code 22): This care may be covered by another payer per coordination of benefits.
Who pays
OA-22. Other adjustment: used when neither CO nor PR applies, often for coordination with another payer.
What to do
- Call the plan and update your other-insurance information (or confirm you have none).
- Ask them to reprocess the claim.
- If you do have two plans, make sure the primary one was billed first.
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.