PR-148: Information from Another Provider Not Provided or Incomplete
Patient responsibility — review the adjustment and determine if the patient truly owes this amount.
What Does PR-148 Mean?
With PR (Patient Responsibility), the CARC 148 adjustment for information from another provider not provided or incomplete shifts the financial impact to the patient. Before billing the patient, verify that the denial reason is valid. if the underlying issue can be corrected, resubmit the claim first to potentially eliminate the patient's liability.
CARC 148 is used when the payer determines that information from another provider not provided or incomplete. The claim could not be processed as submitted because required information was absent, incomplete, or did not meet the payer's submission standards.
Common scenarios that trigger this adjustment include: the referring provider did not submit the required referral documentation or authorization number, and the payer cannot process the claim without it; Information from the primary insurance provider needed for coordination of benefits was not included or was incomplete on the claim submission; The payer requires clinical documentation from another treating provider (such as an operative report from a surgeon when billing for assistant services) that was not submitted. The group code paired with CARC 148 determines who bears the financial responsibility — CO places it on the provider as a contractual obligation, OA indicates a coordination of benefits or other payer adjustment, PR shifts it to the patient.
How to Resolve
- Review the adjustment Examine the PR-148 adjustment and any RARC codes to understand the basis for the patient responsibility.
- Verify the adjustment is correct Confirm the PR designation and amount are appropriate based on the patient's plan benefits.
- Appeal if incorrect If the adjustment appears incorrect, file an appeal with supporting documentation.
- Collect from the patient if valid If the adjustment is confirmed correct, generate a patient statement and follow standard collection procedures.
This denial indicates information from another provider was missing or incomplete. Obtain the required information from the other provider and resubmit the claim rather than appealing.
How to Prevent PR-148
- Verify patient benefits and financial responsibility before rendering services
- Communicate potential out-of-pocket costs to patients proactively
Also Filed As
The same CARC 148 may appear with different Group Codes: