CARC 293 Active

CO-293: Payment Made to Employer

TL;DR

CO-293 means payment to the employer is contractually mandated. Contact the employer to arrange reimbursement and verify whether your contract requires this payment flow.

Action
Review & Decide
Who Pays
Provider
Appeal
No
Patient Impact
None
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does CO-293 Mean?

When CARC 293 appears with CO, the payer is indicating the payment routing to the employer is a contractual obligation. This may occur under specific self-funded plan arrangements where the employer is the designated payment recipient by contract. The provider's recovery options may be limited to collecting from the employer directly.

CARC 293 appears when the payer has processed a claim and directed payment to the patient's employer instead of the billing provider. This is an unusual code that typically arises in specific payment arrangement scenarios, most commonly with self-funded employer health plans or when coordination of benefits determinations route payment through the employer.

Self-funded employer plans operate differently from fully insured plans. In a self-funded arrangement, the employer assumes the financial risk for employee health claims and often uses a third-party administrator (TPA) to process claims. In some configurations, claim payments are routed through the employer as the plan fiduciary before reaching the provider. CARC 293 tells the provider that the payer processed the claim but directed the funds to the employer entity rather than to the provider's payment address.

This code can also surface when there are errors in payment routing information, incorrect employer group numbers, or when the payer's system is configured to send payments to the employer based on the plan's administrative setup. Regardless of the cause, the provider needs to trace the payment and either have it redirected or collect directly from the employer who received the funds.

How to Resolve

  1. Review contract terms Check your provider agreement to understand if the self-funded plan requires payments to flow through the employer.
  2. Collect from employer If the contract supports this payment flow, contact the employer to collect the provider's portion of the payment.
Do Not Appeal This Code

Payment Made to Employer recorded under CO is a contractual obligation — the provider absorbs this amount per the payer agreement. Without an error in how the contract was applied, appeals don't apply. Review the accompanying RARC codes for context and accept the adjustment when the contract terms were applied correctly.

How to Prevent CO-293

Also Filed As

The same CARC 293 may appear with different Group Codes:

OA-293 PR-293

Related Denial Codes

CO-3 — Co-payment Amount CO-85 — Patient Interest Adjustment CO-100 — Payment Made to Patient/Insured CO-101 — Predetermination: Anticipated Payment CO-105 — Tax Withholding Amount

Sources

  1. https://www.mdclarity.com/denial-code/293
  2. https://resdac.org/sites/datadocumentation.resdac.org/files/Adjustment%20Reason%20Code%20Code%20Table%20(TAF%20Claims).txt
  3. https://x12.org/codes/claim-adjustment-reason-codes
  4. Codes maintained by X12. Visit x12.org for official definitions.