CARC 31: Patient cannot be identified as the payer’s member
The payer could not match the patient to one of its members.
Group code context
Often sent with group code CO.
Common causes
- Wrong subscriber ID or missing prefix
- Name spelled differently from the payer's record
- Wrong date of birth
- Dependent billed under the wrong subscriber
Step-by-step fix
- Check the insurance card and run eligibility again
- Fix the ID, name or date of birth
- Resubmit the claim
Appeal guidance
Usually a correction, not an appeal.
When not to appeal
Do not appeal before checking the member details. Most of these are data errors.
Prevention checklist
- Scan both sides of the insurance card at every visit
- Use real-time eligibility at registration
Related codes
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Source and review
Official source ↗Last checked: 2026-10-05
Reviewed by: PracticeVendors editorial team
Educational reference. Confirm payer instructions and applicable contracts before taking action.