The service was performed before your insurance coverage started. The insurer will not cover services that occurred before your effective date.
Verify your coverage start date. If the service occurred after your start date and the insurer has the wrong date, provide proof of your enrollment. If the service truly was before coverage, you are responsible for the bill.
Appeal outlook: Low unless enrollment date is incorrect
Recommended tool
Bill Advantage can analyze your denial and generate a ready-to-send appeal or dispute letter in minutes.
Open Denial Letter TranslatorDenial codes on your EOB explain why a claim was denied. Learn what the most common codes mean in 2026 and the exact steps to fix or appeal each one.
Read articleWhat to Do When Insurance Denies a ClaimInsurance denied your claim? Learn the exact steps to appeal a health insurance denial in 2026, from reading the denial letter to external independent review.
Read article