CARC174ReferenceCurrentVerified Aug 15, 2026CARC 174
AR Guide Workflow
Eligibility & Coverage
Coverage could not be verified or was not active for the date of service — member not found, coverage lapsed, or eligibility requirements not met.
AR Guide explanation
What it means
The service was not prescribed prior to delivery.
AR Guide knowledge
Common denial category
Eligibility & Coverage — Coverage could not be verified or was not active for the date of service — member not found, coverage lapsed, or eligibility requirements not met.
AR Guide knowledge
Common causes
- Prescription obtained after the service was provided
- Missing prescription documentation
AR Guide knowledge
What AR should verify
- Review the prescription date vs. the service date
AR Guide knowledge
Recommended action
- If the prescription exists and is valid, appeal with documentation
- If the order was truly after delivery, adjust per the plan
About this guidance: Note
AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.