CO-27: Expenses After Coverage Terminated
Expenses incurred after coverage terminated. The date of service is after the patient's coverage end date with this payer.
Why Claims Get Denied with CO-27
Denial code CO-27 is triggered when expenses incurred after coverage terminated. the date of service is after the patient's coverage end date with this payer. Understanding the root causes helps prevent future denials and strengthens your appeal when one occurs.
Patient's coverage was terminated before the date of service
COBRA coverage expired and patient did not renew
Employer terminated coverage and patient was unaware
Patient switched plans and old plan terminated before the service date
How to Appeal CO-27
Verify the patient's coverage termination date with the payer. If coverage was active on the date of service, provide documentation such as premium payment receipts or employer verification of active coverage. If retroactive reinstatement is possible, request it through the employer or marketplace. Bill the patient's current/correct insurer if coverage changed.
Documentation Required for Appeal
A successful appeal of CO-27 requires thorough documentation. Gather these items before drafting your appeal letter:
Proof of active coverage on date of service
Premium payment receipts showing coverage was current
Employer verification of coverage status
COBRA election and payment documentation
How to Prevent CO-27 Denials
Run real-time eligibility verification on the date of service, not just at scheduling. Verify coverage status for patients who have not been seen recently. Confirm COBRA and marketplace coverage renewal dates.
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