CODA audits

The scope of our Claims Opportunity Detection Audits (CODA) program with vendor Performant Recovery Inc. includes duplicate claims for professional, outpatient and inpatient services. These audits appear as denials on your remittance advice with codes GBC, GBF or OZ5. 

Level I disputes

If you receive a claim denial for duplicate services and/or a CODA adjustment and wish to dispute the decision, follow our claim reviews and appeals process.