Health insurance denial & claim adjustment codes

What health insurance denial code 252 means on your EOB

The claim is paused while the plan waits for supporting documentation. This is a process state rather than a final denial, and it frequently stalls silently because the request went to a department that never routed it onward.

What usually causes it

• The plan requested documentation.
• The request has not been fulfilled.
• The records went to the wrong department.

The documents that decide it

• The plan's documentation request.
• What the provider sent, and when.
• Confirmation of receipt.

What to do next

Confirm the provider actually received and responded to the request. These stall silently more often than they are denied.

This page explains what a code means. It is information, not advice — it does not tell you whether your specific claim should have been paid, and it is not legal, medical, or insurance advice. Your plan documents and your denial notice govern your situation.