PR 2: Coinsurance Amount
Applied to patient coinsurance.
Bill the patient. Not a denial.
See a finished review first
- No patient data
- No BAA
- No charge
- No pitch
What PR 2 means
PR: Patient responsibility. This one goes on the patient statement.
So the balance is billable to the patient, provided your advance notice was in order. Check that before the statement goes out. Billing a patient for something you contractually agreed to absorb is the expensive mistake on this code.
Is It Worth Appealing?
Not a denial. A contracted write-down or patient responsibility. Not money you lost.
Why It Fires
In the order we see it.
The plan applied this to coinsurance.
What to Do With PR 2, Step by Step
Bill the patient. Not a denial.
- 1Step 1: Read the remark code. Find the remark code printed next to PR 2 on the 835 or EOB. It says what the payer wants back.
- 2Step 2: Find the cause. Match the denial to one of the cause in Why It Fires above, and fix that one.
- 3Step 3: Do this. Bill the patient. Not a denial.
The common mistake. Not a denial. Bill the patient.
Free: the Denial Code Appeal Playbook. 53 codes on one sheet: appeal, fix and resubmit, or let it go, and what to attach. Get the playbook
PR 2 description
Applied to patient coinsurance.
Applied to patient coinsurance. So the balance is billable to the patient, provided your advance notice was in order. Check that before the statement goes out. Billing a patient for something you contractually agreed to absorb is the expensive mistake on this code.
This is our plain-English wording, not the official X12 text. X12 asserts copyright over the published descriptions, so we write our own and say what it means for the money rather than restating the code.
Where this comes from. This is our own reading of the code, not the payer's and not a copy of the standards text. We classify it from how these denials actually resolve. Where we are unsure, we say so rather than guessing.
Related Codes
Your Questions Answered
What does PR 2 mean?
Applied to patient coinsurance. Patient responsibility. This one goes on the patient statement.
Can you appeal PR 2?
Not a denial. Bill the patient. Not a denial.
Why does PR 2 happen?
The plan applied this to coinsurance.
What do I do with PR 2?
Step 1: Read the remark code. Find the remark code printed next to PR 2 on the 835 or EOB. It says what the payer wants back. Step 2: Find the cause. Match the denial to one cause: The plan applied this to coinsurance. Step 3: Do this. Bill the patient. Not a denial.
Most searched: CO 97 · CO 96 · OA 23 · PR 204 · CO 109 · CO 197 · CO 45 · CO 50
How Much of This Is Sitting in Your Write-Off Pile?
No patient data. No BAA. No charge.
Upload your denial summary for the last 90 days. 4 columns: payer, CARC code, count, billed amount. You get back which were winnable and what they were worth.