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PR-241Patient ResponsibilityPatient Responsibility

PR-241 Denial Code: Low Income Subsidy (LIS) copayment

Medicare Part D LIS copayment amount — the reduced patient share for subsidy-eligible members.

Why PR-241 happens

  • Part D claim for an LIS-eligible beneficiary

How to fix a PR-241 denial

  1. 1

    Collect the LIS copay level, not the standard copay

How to prevent it

Pharmacy systems should apply LIS levels from the eligibility response.

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