M-HIP
Chapter 2 · Group Codes

Eligibility Verification

Catch coverage problems before the visit, not after.

Send us one ERA →
Where it shows up on the ERA
  • PR-1Deductible.
  • PR-2Coinsurance.
  • PR-3Copay.

PR (Patient Responsibility) adjustments are where eligibility failures land on the ERA. Wrong plan, terminated coverage, uncollected deductibles — all show up here.

We run real-time and batch eligibility checks tuned to each payer's quirks, and reconcile patient responsibility daily.

Medical Billing →Denial Management →A/R Follow-up →Credentialing →Billing Audits →