PR-210: Pre-Certification/Authorization Not Received Timely

What Does PR-210 Mean?

With PR (Patient Responsibility), the patient is financially responsible because the authorization was not obtained in time. Collect from the patient. The patient may have contributed to the delay by providing insurance information late.

CARC 210 is specifically about authorization timing — the authorization request was either submitted too late before the service or the post-service notification was not filed within the required window. Unlike CARC 197 (authorization absent entirely), CARC 210 acknowledges that authorization may have been sought but was not received by the payer within their required deadline.

Different payers have different authorization submission deadlines, and some have very short windows for retroactive or post-service notifications. For emergency services, most payers allow a grace period for post-service notification, but this period is often just 24-72 hours. Missing these deadlines can result in full denial of the claim.

Common Causes

How to Resolve

1. Verify the timing issue Confirm the authorization deadline was missed.
2. Communicate with the patient Inform the patient of the charges.
3. Collect from the patient Send a statement and collect.

How to Prevent PR-210

• Verify insurance information and authorization requirements at the earliest point of contact
• Inform patients about their plan's authorization requirements during scheduling

Also Filed As

The same CARC 210 may appear with different Group Codes:

Related Denial Codes