OakClaim
CO-26Contractual ObligationEligibility

CO-26 Denial Code: Expenses incurred prior to coverage

Expenses were incurred before the patient's coverage became effective.

Why CO-26 happens

  • DOS before the policy effective date
  • New coverage keyed with the wrong effective date

How to fix a CO-26 denial

  1. 1

    Verify the coverage effective date

  2. 2

    Bill the plan that was active on the DOS, or the patient if none

How to prevent it

Real-time eligibility at scheduling and check-in.

Drowning in CO-26 denials?

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