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PR-3 - Denial Journal
CARC PR — Patient Responsibility

PR-3

Co-payment amount

What This Code Means

The amount applied is the patient’s fixed co-payment for this type of visit or service.

Common Causes

  • Standard fixed cost-share defined by the plan
  • Copay amount differs for specialist vs. primary care visits

How to Resolve or Appeal

  1. Collect the copay at time of service going forward to reduce A/R
  2. Confirm the copay amount matches the patient's ID card/plan
  3. Bill retroactively if not collected at check-in

More Denial Codes to Check

CARC CO-48 RARC M83 RARC MA33 CARC PR-275 CARC CO-111 RARC M89 CARC CO-47 CARC CO-49 Non-covered: routine/preventive exam or screening performed with a routine exam CARC CO-B1 CARC CO-149 RARC MA20 CARC CO-269

Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.

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