Wiki REASON CODE PR-275

[Pkirsch1]

Is reason code PR-275 patient's responsibility? Is this something new for Blue Cross/Blue Shield?

 

[msbernards]

It is the patient's responsibility. Not sure if it's new or not. Every BC/BS plan is different and I personally haven't seen one as a secondary that doesn't cover for that code, but it is a legit reason.

 

[Pkirsch1]

This plan is secondary.

 

[msbernards]

Best guess is that the BC/BS copay/coinsurance is the same as or higher than primary and they will not cover. I know in Ohio we have an insurance that never covers anything as the secondary. Bill the patient for that primary copay.

 

[tera828@yahoo.com]

Prior payer's (or payers') patient responsibility (deductible, coinsurance, co-payment) not covered