AGAR Guide
CARC200ReferenceCurrentVerified Aug 15, 2026

CARC 200

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.

Open denial workflow

AR Guide explanation

What it means

Expenses were incurred during a lapse in coverage.

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

  • Coverage lapse between terms
  • Service date during an uncovered period

AR Guide knowledge

What AR should verify

  1. Verify the coverage status for the date of service
  2. Confirm the lapse dates

AR Guide knowledge

Recommended action

  1. If coverage was later reinstated retroactively, appeal with the reinstatement
  2. Otherwise 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.