CARC · PR group
PR-96
Non-covered charge(s), patient responsibility
Patient responsibility; billable to the patient
- What it means
- Not covered, and the plan assigns the balance to the patient.
- Likely cause
- Service outside the benefit with a valid waiver or notice on file.
- How to fix it
- Bill the patient only if advance notice exists; otherwise the balance is not defensible and should be written off.
- Revenue impact
- Compliance risk if billed without documented disclosure.
- non-covered
- patient responsibility
- compliance
Related codes
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