Health insurance denial & claim adjustment codes

What health insurance denial code 285 means on your EOB

The appeal went to the wrong place or missed a required step. Procedural, not substantive, and usually curable.

What usually causes it

• The appeal went to the wrong address or department.
• A required form or signature was missing.
• An internal level of appeal was skipped.

The documents that decide it

• The plan's written appeal procedure.
• What you submitted and where.
• The plan's response naming the defect.

What to do next

Ask the plan exactly which step was missed, then refile correctly. Procedural denials rarely affect the merits.

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.