P27 Denial Code - Fix Auto Liability Payment Issues
Code P27 indicates that payment is denied due to jurisdictional regulations or payment policies related to Liability Coverage Benefits. This code specifically applies to Property and Casualty Auto insurance claims. The denial could occur at the claim level or line level, and the remittance advice will include a reference to the applicable insurance policy or healthcare policy identification segment.
Who Pays: Group Code Liability
For code P27, the group code is typically CO, meaning the provider must write off the amount and cannot bill the patient. However, verify with the payer to confirm if any circumstances might allow PR to apply.
Why Claims Get Code P27
- The claim was submitted without considering jurisdictional regulations for Property and Casualty Auto coverage.
- The payer determined that the services were not covered under the specific liability policy.
- Incorrect policy information was provided or not matched with jurisdictional requirements.
- The services did not meet specific payment policies set by the payer.
- The claim was submitted to the wrong payer for Property and Casualty Auto coverage.
How to Fix & Resubmit
- Review the remittance advice for the insurance policy number or healthcare policy identification segment to understand the jurisdictional issue.
- Verify the claim was submitted to the correct Property and Casualty Auto insurance payer.
- Check the details of the liability coverage policy to ensure the services are covered and meet jurisdictional regulations.
- If the policy details are correct, contact the payer for clarification on the denial reason and any documentation requirements.
- Submit a corrected claim if there was an error in the original submission, ensuring all jurisdictional requirements are met.
Corrected Claim or Appeal?
For code P27, submit a corrected claim when the denial results from incorrect policy information or payer submission errors. If the denial is due to legitimate jurisdictional regulations, an appeal is unlikely to succeed and may not be warranted.
Preventing Future P27 Denials
- Verify jurisdictional regulations and payment policies for Property and Casualty Auto claims before submission.
- Ensure accurate and complete policy information is included with the claim.
- Submit claims to the correct payer based on the type of coverage.
- Regularly update staff on jurisdictional changes affecting liability coverage claims.