PR-201Patient ResponsibilityPatient Responsibility
PR-201 Denial Code: Set-aside arrangement — patient responsible
The patient is responsible via a Medicare set-aside or similar arrangement (typically funded from a settlement).
Why PR-201 happens
- ●WC/liability settlement created a set-aside that must pay before Medicare
How to fix a PR-201 denial
- 1
Bill the set-aside administrator/patient per the arrangement
- 2
Document set-aside exhaustion before billing Medicare
How to prevent it
Screen for settlements and MSAs during intake for injury-related care.
Drowning in PR-201 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.