OA-144: Incentive Adjustment for Preferred Product/Service

What Does OA-144 Mean?

When paired with Group Code OA, CARC 144 (Incentive Adjustment for Preferred Product/Service) is processed as an adjustment outside the standard CO/PR classifications. This typically occurs in secondary payer or coordination of benefits scenarios. Review the remittance details and the COB arrangement to determine financial responsibility and appropriate next steps.

CARC 144 means the payer adjusted the payment based on incentive adjustment for preferred product/service. The reimbursement was calculated using the payer's fee schedule, contracted rate, or regulatory payment methodology rather than the billed charge.

Common scenarios that trigger this adjustment include: the provider used a product, device, or medication that is not on the payer's preferred list, and the payer applies an incentive adjustment to encourage use of the preferred alternative; The provider is enrolled in an incentive program such as preferred drug formulary or value-based purchasing but the specific claim does not meet the program's criteria for the incentive payment; The claim was submitted with codes that do not align with the payer's incentive program requirements, preventing the incentive payment from being applied. The group code paired with CARC 144 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, OA indicates a coordination of benefits or other payer adjustment, PR shifts it to the patient.

Common Causes

How to Resolve

1. Review the coordination of benefits Examine the OA-144 adjustment to understand how it fits within the primary/secondary payer relationship or other multi-payer context.
2. Verify primary payer adjudication Review the primary payer's EOB to understand the basis for the secondary payer's OA adjustment.
3. Determine the responsible party Based on the COB review, identify whether the adjustment should be absorbed, billed to another payer, or if additional documentation is needed.
4. Appeal or resubmit if needed If you believe the incentive adjustment was applied in error, file a formal appeal with supporting documentation including the provider contract, incentive program terms, and evidence of preferred product usage.
5. Follow up Monitor the claim status and take additional action as needed based on the COB determination.

Common RARC Pairings

The RARC code tells you exactly what triggered the OA-144:

How to Prevent OA-144

• Verify preferred product/service incentive terms with each payer to understand how incentives are applied across different group code categories
• Document the use of preferred products on all claims to ensure incentive adjustments are applied correctly by each payer
• Track incentive program participation across all payers to anticipate and verify OA incentive adjustments

Also Filed As

The same CARC 144 may appear with different Group Codes:

Related Denial Codes