CARC177ReferenceCurrentVerified Aug 15, 2026CARC 177
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 patient has not met the required eligibility requirements.
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
- Eligibility not verified before service
- Coverage lapsed at time of service
- Member not eligible for the service type
AR Guide knowledge
What AR should verify
- Verify eligibility for the date of service
- Check the plan's eligibility requirements for the service
AR Guide knowledge
Recommended action
- If coverage existed, provide proof and appeal
- If the patient was not eligible, bill per applicable rules
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.