CARC176ReferenceCurrentVerified Aug 15, 2026CARC 176
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 prescription is not current.
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 expired at time of fill
- Refill beyond the prescription's validity
AR Guide knowledge
What AR should verify
- Check the prescription fill dates vs. its validity period
AR Guide knowledge
Recommended action
- Obtain a current prescription and resubmit
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.