Denial Code CO27 is an important and commonly used denial code. CO 27 denial code means patient insurance coverage is terminated on date of service (DOS). It means patient insurance policy is no longer active on DOS.
If insurance is not active on Date of service, means claim should not be paid.
CO 27 Denial Code Descriptions:
CO 27 denial code means patient insurance was not active on DOS. Insurance coverage was terminated before DOS. Services done after policy terminated.
How to Handle CO-27 Denial ?
CO-27 is a very frequent and common denial, when billing company received this denial means insurance on which patient was insured not active on dos. There are some steps to follow for handle coverage terminated denial code.
Step 1 –
Check Patient eligibility on web portal for the insurance which gave the denial code CO27.
- If patient was not active with insurance on DOS then need to find the active insurance. Claim bill to correct active insurance.
- If patient was active then call to insurance and ask for re-process the claim as insurance was active and wrongly denial.
Step 2-
In some cases claim was denied as coverage terminated and found insurance is inactive on dos, but no other insurance found for rebill the claim.
- In this scenario we follow the SOP guidelines, SOP says claim should billed to patient then follow the same.
- In some cases as SOP claim sent for client review so follow the SOP, no directly billed to patient.
Denial Code CO-27 is also part CO-26 and CO-28, all three denial have same explanation but with some difference.
CO-27 – Coverage terminated on DOS.
CO-26- Expense was incurred prior to patient insurance coverage effective.
CO-28 – Coverage was active as time of service provided.
Please handle this as per specific denial received. 99% you have to follow the same steps.