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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

  1. 1Verify deductible status with payer
  2. 2Collect from patient
  3. 3Ensure correct patient benefit information is on file

Related Patient Responsibility Codes