CARC27ReferenceCurrentVerified Aug 15, 2026CARC 27
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
Expenses were incurred after the patient's coverage terminated.
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
- Service date after coverage end date
- Coverage retroactively terminated
- Incorrect effective/termination dates on file
AR Guide knowledge
What AR should verify
- Verify the coverage end date on file
- Compare the date of service to the coverage period
AR Guide knowledge
Recommended action
- If coverage data is wrong, correct it and resubmit
- If the patient was truly uncovered, bill the patient 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.