CO-296Contractual ObligationAuthorization
CO-296 Denial Code: Auth valid but not for this provider
The authorization is real but names a different provider — services were rendered by someone the auth doesn't cover.
Why CO-296 happens
- ●Provider substitution after auth (coverage, scheduling) without updating the auth
- ●Group-level vs individual-provider auth mismatches
How to fix a CO-296 denial
- 1
Request an auth amendment to the actual provider; appeal citing same-group/same-specialty continuity where policy allows
How to prevent it
Re-verify auth provider match when schedules change.
Drowning in CO-296 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.