PR-27Patient ResponsibilityEligibility
PR-27 Denial Code: Expenses incurred after coverage terminated (patient liability)
Expenses incurred after the patient's coverage terminated; the payer assigns responsibility to the patient.
Why PR-27 happens
- ●Coverage termed before date of service and no other coverage found
- ●Patient did not disclose loss of coverage
How to fix a PR-27 denial
- 1
Re-verify eligibility and ask the patient for any new coverage
- 2
If newly insured, bill the new plan; otherwise bill the patient
- 3
Offer self-pay pricing or payment plans where appropriate
How to prevent it
Verify eligibility at scheduling AND at check-in; capture coverage changes immediately.
Drowning in PR-27 denials?
OakClaim works every denial within 48 hours and builds prevention rules so they stop recurring.