CARC · PR group
PR-119
Benefit maximum reached, patient responsibility
Patient responsibility; billable to the patient
- What it means
- The plan cap is exhausted and remaining charges fall to the patient.
- Likely cause
- Session limits hit mid-year with no benefit tracking at scheduling.
- How to fix it
- Track remaining visits per patient and convert to a self-pay agreement before the cap, not after.
- Revenue impact
- Collectible with advance notice; otherwise a write-off and an unhappy patient.
- benefit maximum
- patient responsibility
- prevention
Related codes
Early access
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