CARC Code
27
Expenses incurred after coverage terminated.
40%
Recovery Rate
20-45 days
Avg. Resolution
Medium
Difficulty
Occasional
Frequency
Recommended Action
Verify termination date and bill patient if services post-date termination
Step-by-Step Resolution
- 1
Verify patient coverage termination date with the payer immediately
- 2
Check if COBRA coverage was elected and if it was active on the date of service
- 3
Determine if the employer terminated the group coverage retroactively
- 4
If termination was retroactive employer action, request appeal with HR documentation
- 5
If coverage was legitimately terminated, bill patient directly with financial responsibility notice
- 6
Implement real-time eligibility verification to catch terminations at check-in
Common Remark Codes (RARC)
These RARC codes often appear alongside CARC 27 on remittance advice.
→ Check payer termination records and COBRA election status
Payer-Specific Notes
How major payers handle CARC 27 in practice.
General
Group plan terminations often effective end of month of employment end; verify exact date
Delta Dental
COBRA elections allow continuation; confirm COBRA premium payment status
Common 835 Combinations
CARC 27 most often appears with these Group Code + RARC combinations on 835 remittances.
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