OA-101Other AdjustmentPayment Adjustment
OA-101 Denial Code: Predetermination — no payment yet
This was a predetermination response, not a payment: it estimates what the plan expects to pay once actual services are billed.
Why OA-101 happens
- ●Predetermination request processed and reported through the remit
How to fix a OA-101 denial
- 1
File the actual claim after services; don't post predetermination as payment
How to prevent it
Route predetermination responses to the auth team, not payment posting.
Drowning in OA-101 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.