OA-302: Authorization Time Limit Expired

What Does OA-302 Mean?

OA-302 signals that the authorization time limit expiration does not fit neatly into provider responsibility (CO) or patient responsibility (PR). This pairing typically appears in coordination of benefits scenarios where the responsibility for obtaining or maintaining the authorization is shared or unclear between parties — for example, when a referring provider was supposed to secure authorization but the rendering provider submitted the claim. The financial resolution depends on determining which party failed to meet the authorization deadline.

When CARC 302 appears on a remittance, the payer is telling you that the time limit for obtaining precertification, notification, authorization, or pre-treatment approval has lapsed. This is not a question of whether the service was medically necessary or correctly coded — it is purely a procedural timing issue. The payer set a deadline for the authorization to be secured, and that deadline was not met before the claim was processed.

This code typically surfaces when a provider either never initiated the authorization process, started it too late, or obtained a valid authorization that expired before the service was rendered. It can also appear when a payer required advance notification of a planned treatment within a specific timeframe and that notification was not sent. The distinction matters because each scenario has a different resolution path — a never-requested authorization is harder to recover than one that was requested on time but processed slowly by the payer.

CARC 302 is overwhelmingly paired with Group Code CO, placing the financial responsibility squarely on the provider. Since the payer views this as a provider-side administrative failure, the adjustment cannot be billed to the patient under most payer contracts. However, if you can document that the authorization request was submitted within the required window or that the payer's own processing delays caused the expiration, you have grounds for a strong appeal.

How to Resolve

Verify whether the authorization was requested within the required timeframe, then either appeal with documentation of timely efforts or request a retroactive authorization.

1. Identify the responsible party for authorization Determine whether the authorization was the responsibility of the referring provider, the rendering provider, the facility, or another party in the care chain. Review referral documentation and payer requirements to establish who should have obtained the authorization.
2. Coordinate with the responsible party If another provider or facility was responsible for the authorization, contact them to obtain the authorization documentation or request that they assist with the appeal. If the authorization was your responsibility, proceed with the standard CO-302 resolution path.
3. Submit to the appropriate payer in the COB sequence If this is a COB situation, verify that the claim was submitted to the correct payer in the billing sequence and that the authorization requirement applies to this specific payer. The authorization may have been obtained for the primary payer but not the secondary.
4. Resolve the remaining balance Once the responsible party is identified and the authorization status is clarified, either appeal with the appropriate payer, obtain a retroactive authorization, or determine whether the remaining balance should be written off or forwarded to the next payer.

Common RARC Pairings

The RARC code tells you exactly what triggered the OA-302:

How to Prevent OA-302

• Clarify authorization responsibility at the time of referral — document in writing which party is responsible for obtaining and maintaining the authorization
• Verify authorization status with the payer before rendering services, regardless of which party was supposed to obtain it
• In COB scenarios, confirm authorization requirements with each payer in the billing sequence independently

Also Filed As

The same CARC 302 may appear with different Group Codes:

Related Denial Codes