Denial Code 14 (CARC) means that the date of birth follows the date of service. Below you can find the description, common reasons for denial code 14, next steps, how to avoid it, and examples.
2. Description
Denial Code 14 is a Claim Adjustment Reason Code (CARC) and is described as ‘The date of birth follows the date of service’. This indicates that the date of birth provided for the patient is after the date of service on the claim. In simpler terms, the insurance company will not process the claim because the date of birth is not valid for the date of service.
2. Common Reasons
The most common reasons for denial code 14 are:
- Data Entry Errors: Denial code 14 often occurs due to data entry errors where the date of birth is mistakenly entered after the date of service. This can happen when there is a typo or when the person entering the information is not paying close attention to the details.
- Inaccurate Patient Information: Sometimes, denial code 14 is triggered when the patient’s date of birth is not correctly recorded in the system. This can happen if the patient provides incorrect information or if there is a mistake made during the registration process.
- Outdated or Invalid Dates: In some cases, the denial may occur because the date of service or the date of birth is outdated or invalid. This can happen if the claim is submitted long after the service was provided or if the patient’s date of birth is not within a valid range.
- System Glitches: Occasionally, denial code 14 may be the result of a system glitch or technical issue. This can happen if there is a problem with the software or if there is a mismatch between the date of birth and the date of service in the system.
3. Next Steps
You can fix denial code 14 as follows:
- Double-Check Data Entry: The first step is to double-check the data entry for both the date of birth and the date of service. Ensure that there are no typos or mistakes in the dates entered. If there is an error, correct it and resubmit the claim.
- Verify Patient Information: Verify the patient’s date of birth with the patient themselves or with their official identification documents. Make sure that the date of birth recorded in the system is accurate. If there is a discrepancy, update the patient’s information and resubmit the claim.
- Review Claim Submission Timeline: Check the timeline for claim submission and ensure that the claim is being submitted within the required timeframe. If the claim is being submitted late, determine if there are any extenuating circumstances that may allow for an exception to be made.
- Contact Technical Support: If you suspect that the denial is due to a system glitch or technical issue, contact the technical support team for your billing software or system. Provide them with the details of the denial and ask for assistance in resolving the issue.
4. How To Avoid It
You can prevent denial code 14 in the future as follows:
- Implement Data Validation Checks: Use data validation checks in your billing software or system to ensure that the date of birth is entered correctly and is within a valid range. This can help catch errors before the claim is submitted.
- Train Staff on Data Entry: Provide training to your staff on the importance of accurate data entry, especially when it comes to dates. Emphasize the need to double-check the dates and to pay attention to details to avoid errors.
- Regularly Update Patient Information: Encourage patients to provide updated and accurate information, including their date of birth. Regularly review and update patient records to ensure that the information in the system is current.
- Monitor System Performance: Regularly monitor the performance of your billing software or system to identify any potential glitches or technical issues. Address these issues promptly to minimize the risk of denials due to system errors.
5. Example Cases
Below are two examples of denial code 14:
- Example 1: A claim is submitted for a medical procedure performed on January 15, 2022, but the date of birth entered for the patient is February 1, 2022. The claim is denied under code 14 because the date of birth follows the date of service.
- Example 2: A claim is submitted for a laboratory test conducted on March 1, 2022, but the patient’s date of birth in the system is recorded as March 5, 2022. The claim is denied under code 14 because the date of birth is after the date of service.
