NextGen Knowledge Center

CARC and RARC Codes

The following table states the various councils and abbreviations used for remittance operating rule.

Table 1. Acronyms and Definitions
Council/CodesDescription
Council for Affordable Quality Healthcare (CAQH)An American non-profit organization that collaborates with healthcare providers, trade associations, and insurers.
Committee on Operating Rules for Information Exchange (CORE)A multi-stakeholder initiative developing operating rules that streamline electronic healthcare administrative data exchange and support interoperability between payers and providers.
Claim Adjustment Reason Codes (CARC)Used to provide an overall explanation for the financial adjustment to the amount submitted on a claim.
Remittance Advice Remark Codes (RARC)There are two types of RARC codes:
  • Supplemental: Used to provide additional explanation for an adjustment already described by a CARC.
  • Informational: Used to convey information about remittance processing. These codes are prefaced with "Alert" and are not related to a specific adjustment or CARC.

CARC / RARC Import Posting Report Columns

ERA Import Posting report in NextGen® Enterprise PM includes the CARC / RARC combinations reported in 835 transaction files to be compliant with the CAQH CORE 360 Rule.