CARC 26: Expenses incurred prior to coverage
The service was performed before your insurance coverage was active.
What this means for your claim
Your insurance will only pay for services rendered while you were an active member. Anything before your effective date is your full responsibility.
What to do next
- 1
Verify your coverage effective date in your plan documents or member portal.
- 2
If your coverage was retroactively activated (e.g., Medicaid retroactive enrollment), ask your insurer to reprocess with the updated effective date.
- 3
If the date of service is clearly during an active coverage period, ask the insurer to verify the member records — a data entry error may have caused this.
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