CARC180ReferenceCurrentVerified Aug 15, 2026CARC 180
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 residency 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
- Residency requirement not met
- Patient out of the plan's service area
AR Guide knowledge
What AR should verify
- Confirm the patient's residency at the time of service
- Review the plan's residency requirements
AR Guide knowledge
Recommended action
- If the patient met the requirement, appeal with documentation
- If not, bill per plan 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.