Healthcare Error Code
Healthcare Insurance / Medical Billing
Patient Responsibility (PR)

PR-2 | Coinsurance

Industry
Healthcare
Canonical
/healthcare/error-codes/pr-2/
Last Updated
Feb 25, 2026
Summary

This code indicates that the patient is responsible for a percentage of the covered charges.

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What This Code Means

PR-2 reflects the coinsurance portion assigned to the patient after insurance payment. Coinsurance represents a shared cost arrangement between the insurer and patient. This is a normal benefit structure, not a denial. The service remains covered, with costs divided according to plan terms.

Where Users Usually See This Code

  • Explanation of Benefits
  • Patient billing statements
  • Remittance advice

Why This Code Appears

  • Coinsurance applies after deductible
  • Plan cost-sharing requirements
  • Coverage percentage rules enforced

What Typically Happens Next

  • Patient balance includes coinsurance amount
  • Claim processing is complete
  • Remaining charges are settled

What This Code Is Not

  • It is not a non-covered charge
  • It is not a billing error
  • It is not a contractual adjustment

Troubleshooting Checklist

  • Review plan coinsurance terms
  • Confirm applied percentages
  • Monitor benefit summaries

Notes And Edge Cases

Coinsurance percentages vary by plan. Out-of-network services may have different rates.

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