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1
PR - Patient ResponsibilityPatient Responsibility
Denial Code PR-1: Deductible Amount
What Does Code 1 Mean?
The amount applied to the patient's deductible. This is a patient responsibility amount, not a denial per se, but frequently confuses providers.
Group Code PR (Patient Responsibility): The patient is responsible for this amount (deductible, copay, coinsurance, non-covered services).
Why Does This Happen?
Patient has not yet met their annual deductible.
How to Resolve It
- 1Verify deductible status with payer
- 2Collect from patient
- 3Ensure correct patient benefit information is on file
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