What is remark code N130?

This service/equipment/drug is not covered under the patient’s current benefit plan. Remark Code: N130. Consult plan benefit documents/guidelines for information about restrictions for this service.

What is denial code PR 32?

PR 32 Our records indicate that this dependent is not an eligible dependent as defined. PR 33 Claim denied. Insured has no dependent coverage. PR 34 Claim denied. Insured has no coverage for newborns.

What does denial code PR mean?

Patient Responsibility
What does the denial code PR mean? PR Meaning: Patient Responsibility (patient is financially liable). A provider is prohibited from billing a Medicare beneficiary for any adjustment amount identified with a CO group code, but may bill a beneficiary for an adjustment amount identified with a PR group code.

What does pr204 mean?

PR-204: This service, equipment and/or drug is not covered under the patient’s current benefit plan.

What does expenses incurred prior to coverage mean?

Payers will deny the claims with CO 26 Denial Code – Expenses incurred prior to coverage, whenever the providers perform health care services to patient prior to the insurance coverage starts.

What does PR mean in insurance?

PR (Patient Responsibility) is used to identify portions of the bill that are the responsibility of the patient. These could include deductibles, copays, coinsurance amounts along with certain denials. If the patient did not have coverage on the date of service, you will also see this code.

What does PR 1 mean on an EOB?

PR 1 Deductible Amount Member’s plan deductible applied to the allowable benefit for the rendered service(s). PR 2 Coinsurance Amount Member’s plan coinsurance rate applied to allowable benefit for the rendered service(s).

What is reason code pr204?

Denial Reason, Reason and Remark Code PR-204: This service, equipment and/or drug is not covered under the patient’s current benefit plan.