Denial Code CO-27 – Expenses incurred after coverage terminated.
Insurance will deny the claim as Denial Code CO-27 – Expenses incurred after coverage terminated, when patient policy was termed at the time of service. It means provider performed the health care services to the patient after the member insurance policy terminated.
Solutions:
Please take the below action, when you receive the Denial Code CO-27.
- First check eligibility through particular website or reach out the customer service department to confirm policy effective and termination date.
- After checking if you come across patient policy is active at the time service provided, then send the claim back for reprocessing.
- Suppose if patient policy was termed at the time service provided, then the next step is to check in application or contact subscriber to see patient has any other active insurance at the time service provided.
- If active insurance found at the time service provided, please update and file the claim.
- If member doesn’t have any other active insurance, bill the patient.
You can reach out the insurance claims department with the following questions to resolve the below denial:
- May I know Patient policy effective and termination date?
- May I know the claim Number?
- May I know the call reference Number?
- If patient policy is active: Inform same with the rep stating patient policy is active at the time of service and it’s denied incorrectly.
- If patient policy is inactive: Next step is to check with rep, whether member has any other active insurance or policy
- Please recheck and send the claim back for reprocessing.
- Obtain Insurance Name, Member ID# and insurance contact details to check eligibility and file the claim.
- Final step is to check in software application or reach out member to obtain other active insurance details. If not available “Bill Patient”.
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