What PR-2 means
The amount is the patient's coinsurance percentage per their benefit plan. Correct in most cases — review only if the wrong plan type or benefit tier was applied.
Common causes
- Standard coinsurance under the patient's plan
- Wrong benefit tier applied (e.g., specialist vs. PCP rate)
- Out-of-network coinsurance applied to an in-network visit in error
How to appeal PR-2
Confirm the correct benefit tier and network status. If the wrong coinsurance rate was applied (e.g., out-of-network rate for an in-network provider), appeal with proof of in-network status. Otherwise, this is a legitimate patient-responsibility balance.
Skip the manual work
Remitavo drafts a payer-specific PR-2appeal — citing the carrier's own policy — straight from your remittance file. Send a sample and we'll show you.
Founding partner program
See what you're leaving on the table — free
Send a sample remittance file and we'll return a ranked recovery worklist plus three ready-to-send appeal letters. No commitment, no integration.