What PR-2 means
The patient's coinsurance share of the allowed amount. The patient owes it, or their secondary insurance may pay it.
Common causes
- Plan pays a percentage after the deductible; the rest is coinsurance
How to fix it
- Bill the secondary payer if there is one, then the patient
- Estimate coinsurance at check-in
Check the remark code (RARC) that came with the denial and the payer's own policy, since rules vary by payer and plan. This is a plain-English summary written by GetMax; the official code text is published by X12 at x12.org/codes.
Prevent it next time
Most denials are caused before the claim is sent. See 12 ways to reduce claim denials, or let our denial management team work them for you.