CO-24Contractual ObligationEligibility
CO-24 Denial Code: Covered under capitation agreement / managed care plan
Charges are covered under a capitation agreement or managed care plan.
Why CO-24 happens
- ●Fee-for-service claim submitted for a capitated member
- ●Patient assigned to a different PCP/IPA
- ●Medicare Advantage member billed to traditional Medicare
How to fix a CO-24 denial
- 1
Verify the member's plan type and capitation assignment
- 2
Bill the correct managed care entity or write off if within your cap agreement
How to prevent it
Flag capitated plans during eligibility verification.
Drowning in CO-24 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.