EOB denial code PR-1: what it means

What it means

This amount was applied to your plan deductible — the amount you pay out of pocket each year before your insurer starts paying its share.

Patient Responsibility — an amount the patient owes, such as a deductible, copay, coinsurance, or non-covered service.

Official X12 description

“Deductible Amount”

Typical cause

Your claim was processed correctly, but you had not yet met your annual deductible, so this portion is your responsibility.

What to do next

1. 1Check your plan's annual deductible and how much of it you have already met this year.
2. 2Confirm the date of service falls inside the plan year you expect.
3. 3If you believe the deductible was already met, ask your insurer for a year-to-date accumulator statement.