OakClaim
CO-180Contractual ObligationEligibility

CO-180 Denial Code: Residency requirements not met

The patient doesn't meet the plan/program's residency requirement (state programs, regional plans).

Why CO-180 happens

  • Patient moved out of the plan's service area
  • State program billed for a non-resident

How to fix a CO-180 denial

  1. 1

    Confirm current residency and correct program; route to the right state/plan

How to prevent it

Confirm address changes at check-in — they often signal coverage changes too.

Drowning in CO-180 denials?

OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.

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