CO-44: Subscriber/Patient Not Eligible on Date of Service
CO (Contractual Obligation)What is CO-44?
CO-44 is a Contractual Obligation code indicating the patient or subscriber was not eligible for benefits on the date of service. The payer's records show the patient's coverage was not active when the service was rendered.
Why Does CO-44 Occur?
- Coverage had not started on the date of service.
- Coverage was terminated before the date of service.
- Patient was in a waiting period for the specific benefit.
- Payer's enrollment records have not been updated to reflect current eligibility.
How to Fix CO-44 Denials
- Verify the patient's eligibility for the date of service using a 270/271 eligibility transaction or the payer portal.
- If the patient is eligible, submit proof of coverage to the payer and request reprocessing.
- If the patient has different coverage, identify the correct payer and submit the claim.
- If no coverage exists for the date of service, bill the patient as self-pay.
CO-44 by Payer
| Payer | Common RARC | Appeal Deadline | Notes |
|---|---|---|---|
| UnitedHealthcare | Varies | 60 days from remittance | Reconsideration required before formal appeal. |
| Anthem | Varies | 365 days from denial notice | Check state-specific provider manual for variations. |
| Aetna | Varies | 180 days from denial | Strict in-network filing enforcement. |
| Cigna | Varies | 180 days from denial | Cigna COB team: 1-800-244-6224. |
| Medicare | Varies | 120 days (redetermination at MAC) | Five levels of appeal starting with MAC redetermination. |
Related CARC Codes
If you are seeing CO-44, check these related codes: CO-44 (subscriber not eligible), CO-27 (coverage terminated), CO-26 (prior to coverage).
Common Questions About CO-44
What does CO-44 mean?
CO-44 indicates subscriber/patient not eligible on date of service. Check the RARC code on the EOB for the specific reason and follow the resolution steps above.
Can I appeal a CO-44 denial?
Yes. Commercial payers allow 60-365 days to appeal depending on the payer. Gather supporting documentation before filing. Medicare allows 120 days for a redetermination request.
Altair catches CO-44 denials before submission with real-time eligibility verification. See how pre-submit claim scoring works.