AGAR Guide
CARC201ReferenceCurrentVerified Aug 15, 2026

CARC 201

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 patient is responsible for this amount through a set-aside arrangement or other agreement. Used with group code PR.

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

  • Workers' compensation set-aside
  • Liability settlement arrangement

AR Guide knowledge

What AR should verify

  1. Review the set-aside or agreement documentation

AR Guide knowledge

Recommended action

  1. Bill the patient per the agreement terms
  2. Document the arrangement in the account notes

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.