CARC209ReferenceCurrentVerified Aug 15, 2026CARC 209
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
Per regulatory or other agreement, the provider cannot collect this amount from the patient, but it may be billed to a subsequent payer.
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
- Regulatory rule prevents patient billing
- Amount must be transferred to the next payer
AR Guide knowledge
What AR should verify
- Confirm the regulatory or agreement basis
- Identify the next payer to bill
AR Guide knowledge
Recommended action
- Bill the subsequent payer
- Do not bill the patient for this amount
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.