What is PR 3 on EOB?

Description: Copayment A specified dollar amount or percentage of the charge identified that is paid by a beneficiary at the time of service to a health care plan, physician, hospital, or other provider of care for covered service provided to the beneficiary.

What does PR mean on an EOB?

PR = Patient Responsibility. Note: The Group, Reason and Remark Codes are HIPAA EOB codes and are cross-walked to L&I’s EOB codes.

What is pr2 on EOB?

PR-2 indicates amount applied to patient co-insurance.

What is a reason code?

Reason codes, also called score factors or adverse action codes, are numerical or word-based codes that describe the reasons why a particular credit score is not higher. For example, a code might cite a high utilization rate of available credit as the main negative influence on a particular credit score.

What is a code PR?

A PR code is a production code given to each piece of equipment installed in your vehicle and is used by manufacturers including VW, Audi, Seat, and Skoda. PR Codes contain three characters comprising of letters and numbers. An example of a PR code is 1KY and it may refer to the vehicle’s brakes.

What is PR 2 denial code?

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

What does PR mean in medical billing?

PR (Patient Responsibility): It is used for deductible, coinsurance and copay when the adjustments represent an amount that should be billed to the patient or the secondary insurance.

What is PR 243 insurance denial code?

243 Services not authorized by network/primary care providers.

What is the difference between reason code 3 and 4?

Reason Code 3: The procedure/ revenue code is inconsistent with the patient’s age. Reason Code 4: The procedure/revenue code is inconsistent with the patient’s gender. Reason Code 5: The procedure code is inconsistent with the provider type/specialty (taxonomy). Reason Code 6: The diagnosis is inconsistent with the patient’s age.

What is the purpose of the reason code?

This reason code list will help you to identify the actual reason of adjustment or reduced payment. If the reason code is valid, you can pass the same information to patient for their responsibility of payment in the statement.

What are PR 25 and PR 31 mean?

PR 25 Payment denied. Your Stop loss deductible has not been met. PR 26 Expenses incurred prior to coverage. PR 27 Expenses incurred after coverage terminated. PR 31 Claim denied as patient cannot be identified as our insured.

What does PR 32 mean on a tax return?

The “PR” is a Claim Adjustment Group Code and the description for “32” is below. The Claim Adjustment Group Codes are internal to the X12 standard. These codes generally assign responsibility for the adjustment amounts. The format is always two alpha characters.