How do I resolve a CO-200 denial?

Verify patient eligibility via the payer's real-time eligibility portal Confirm the subscriber name and member ID match payer records exactly See full resolution steps at tryarceum.com.

Can I appeal a CO-200 denial?

Yes. Most CO-200 denials can be appealed within 60-180 days depending on payer. This is appealable if you have documentation proving the patient had active coverage on the date of service or if the payer's eligibility records are incorrect. Use our free tool to generate an appeal letter.

CARC Code

200

🔴 Hard Denial

Services During Coverage Lapse

The claim was denied because the patient received services during a time period when their insurance coverage had lapsed or was inactive. The patient had no active coverage on the date of service.

eligibility

Resolution: 35%Hard difficulty21-45 days avg

How to resolve this denial

Which payer denied this claim?

Verify coverage gap; explore COBRA or retroactive enrollment options; bill patient

1
Verify patient eligibility via the payer's real-time eligibility portal
2
Confirm the subscriber name and member ID match payer records exactly
3
Check effective and termination dates of coverage
4
If eligibility is confirmed, resubmit with corrected demographic information
5
If coverage is confirmed inactive, discuss patient responsibility or secondary insurance

Resolve this denial →

▶✓ Pre-action checklist — verify before contacting the payer

Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.

▶More about CO-200 — stats, related codes, appeal template

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Occasional

Frequency

Payer-Specific Notes

How major payers handle CARC 200 by specialty.

Blue Cross Blue Shield

BCBS requires appeal submission within 180 days for most plans.

Common 835 Combinations

CARC 200 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-200This code indicates services were rendered during a period when the patient's

Look up any combination →

Appeal Letter Template

Generic appeal template for CARC 200 denials.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 200 indicating: "Expenses incurred during lapse in coverage.." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

Generate a personalized appeal letter →

Need to resolve this denial?

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