PR-31: Patient cannot be identified as insured
UPDATED JULY 2026 · U.S. PLANS · NOT LEGAL OR MEDICAL ADVICE
The payer couldn't match you to an active policy — usually a typo in the ID, name, or date of birth on the claim.
PR-31 at a glance
- Code group: PR — Patient Responsibility — the payer assigns this amount to you (verify before paying).
- Who usually fixes it: You and the billing office together.
- Worth appealing? Sometimes — depends on the facts.
What to do about a PR-31 denial
- Give the provider's office a photo of your current insurance card and confirm your details.
- Have the claim resubmitted with corrected identifiers.
- If you were enrolled but the payer's file is wrong, escalate to the insurer's enrollment team with proof.
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