Official CARC description: “Coinsurance amount.” Here’s what it actually means, why it fires, and how to get the claim paid.
The patient's percentage share after the deductible. Pure patient liability — the tasks are verifying the percentage and collecting well, not appealing.
Liability group: PR = Patient Responsibility — the amount can be billed to the patient (deductible, coinsurance, non-covered care) — but only after you verify the denial is correct. Mis-grouped PR denials are a common appeal win.
Also written: PR-2, PR2, “denial code 2”, “2 denial code” or “reason code 2” — same CARC, different ERA formatting.
Verify the percentage matches the plan's benefit summary
Processed OON wrongly? Fix network status — that changes the patient's share
Bill any secondary/Medigap before statementing the patient
Offer card-on-file and estimates at scheduling for chronic-visit patients
Nothing to appeal when the math is right. Dispute only mis-set percentages or wrong network status — both change the patient's share materially.
Fill in the denial facts — use placeholders, never real patient data (the letter keeps [PATIENT NAME]-style fields so you can merge real details privately). A payer-ready draft with an enclosure checklist comes back in ~20 seconds.
Your appeal letter draft will appear here.
The official CARC description for PR 2 is: “Coinsurance amount.” In practice: The patient's percentage share after the deductible. Pure patient liability — the tasks are verifying the percentage and collecting well, not appealing.
Denial code 2 under the PR group (Patient Responsibility) means: Coinsurance amount. The number is the reason; the PR prefix decides who is liable — the amount can be billed to the patient (deductible, coinsurance, non-covered care) — but only after you verify the denial is correct. Mis-grouped PR denials are a common appeal win.
Yes. PR 2, PR-2, PR2 and “denial code 2” are the same CARC — clearinghouses, payer portals and PM systems just print it differently. Only the group prefix (CO, PR, OA or PI) changes the meaning, because it changes who has to absorb the amount.
PR stands for Patient Responsibility — the amount can be billed to the patient (deductible, coinsurance, non-covered care) — but only after you verify the denial is correct. Mis-grouped PR denials are a common appeal win.
Nothing to appeal when the math is right. Dispute only mis-set percentages or wrong network status — both change the patient's share materially.