What CO-27 means
The patient's insurance coverage was not in effect on the date of service. Appealable when coverage was actually active and the termination data is wrong, or when a retroactive enrollment applies.
Common causes
- Coverage lapsed due to non-payment of premium
- Employer group plan terminated or the patient changed jobs
- Payer has a data error — coverage was actually active
How to appeal CO-27
Verify eligibility on the date of service directly with the payer. If coverage was active, request reconsideration with proof of eligibility (ID card, employer verification, payer confirmation). If the patient genuinely lost coverage, explore Medicaid, secondary insurance, or hardship provisions.
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