CO-45
Charge above the allowed amount
Not a denial: it's the network discount. With CO-45, an in-network provider can't bill you the difference between their charge and the allowed amount.
Official meaning (X12 code 45): Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.
Who pays
CO-45. 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
- If you're billed for a CO-45 amount by an in-network provider, dispute it: that's balance billing.
- Out-of-network? Check the No Surprises Act.
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.