AGAR Guide
CARC2ReferenceCurrentVerified Aug 15, 2026

CARC 2

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.

Open denial workflow

AR Guide explanation

What it means

The amount was applied toward the patient's coinsurance, the patient's share of allowed charges after the deductible.

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

  • Contractual coinsurance percentage applied by the plan
  • Patient's benefit design specifies a higher coinsurance

AR Guide knowledge

What AR should verify

  1. Confirm the coinsurance percentage matches the patient's benefit plan
  2. Verify the allowed amount used for the calculation

AR Guide knowledge

Recommended action

  1. Bill the patient the coinsurance amount per the plan
  2. If the percentage looks wrong, request the claim calculation detail

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.