CARC239ReferenceCurrentVerified Aug 15, 2026CARC 239
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 claim spans eligible and ineligible periods of coverage. Rebill as separate claims.
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
- Claim covers dates inside and outside the coverage period
AR Guide knowledge
What AR should verify
- Split the claim at the coverage boundary
- Confirm the coverage dates on file
AR Guide knowledge
Recommended action
- Rebill as separate claims for each coverage period
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.