PR-1: Deductible
UPDATED JULY 2026 · U.S. PLANS · NOT LEGAL OR MEDICAL ADVICE
The claim was applied to your annual deductible — covered, but you pay until the deductible is met.
PR-1 at a glance
- Code group: PR — Patient Responsibility — the payer assigns this amount to you (verify before paying).
- Who usually fixes it: You (the member).
- Worth appealing? Rarely — usually fixed by resubmission.
What to do about a PR-1 denial
- Verify the deductible math on your EOB against your plan's accumulator (member portal).
- Check that in-network claims weren't applied to a separate out-of-network deductible.
- You still get the negotiated rate — never pay billed charges above the allowed amount.
Denied? Don’t drop it
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