PR-96Patient Responsibility
Non-covered charge -- patient responsibility
What this code means
This service is not covered by your plan and you are responsible for the full amount. This is the patient responsibility version of CO-96.
What to do next
Review your plan exclusions list. Check whether a state mandate applies. If you believe the service should be covered, appeal with documentation. Ask your provider whether a financial assistance program applies.
Appeal outlook: Low to moderate
Recommended tool
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Open Medical Bill Financial Assistance