Denial Code PR-1: Description, Meaning and How to Fix It
This amount is applied to the patient's deductible and is the patient's responsibility.
Official description
Deductible amount.
Common cause
The patient has not yet met their plan deductible.
How to fix it
Bill the patient for the deductible amount. Verify deductible status at eligibility so you can collect up front.
Related denial codes
- PR-2: This amount is the patient's coinsurance and is their responsibility.
- PR-3: This amount is the patient's copay and is their responsibility.
- CO-45: The amount billed is higher than the payer's contracted (allowed) rate. The difference is a contractual write-off, not a patient balance.
- CO-16: The claim is missing required information or has an error. It is almost always paired with a RARC that names the specific missing field.
- CO-97: This service is bundled into another service that was already paid, so it is not paid separately.
- CO-18: The payer received this exact claim/service already.