CARC1ReferenceCurrentVerified Aug 15, 2026CARC 1
AR Guide Workflow
Patient Responsibility
The amount is the patient's responsibility under the plan — deductible, coinsurance, copayment, or a non-covered amount the patient may be billed.
AR Guide explanation
What it means
The amount was applied toward the patient's deductible before the plan paid its share.
AR Guide knowledge
Common denial category
Patient Responsibility — The amount is the patient's responsibility under the plan — deductible, coinsurance, copayment, or a non-covered amount the patient may be billed.
AR Guide knowledge
Common causes
- Patient's annual deductible not yet met at time of service
- Deductible applied per the benefit plan design
AR Guide knowledge
What AR should verify
- Verify the patient's deductible status for the plan year
- Confirm the deductible is satisfied for the correct benefit period
AR Guide knowledge
Recommended action
- Bill the patient per the plan's patient-responsibility rules
AR Guide knowledge
QA checkpoint
- Confirm deductible was verified at the time of service
- Check for coordination-of-benefits impact on the deductible
About this guidance: Note
AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.