Wiki Medicare denial code PR-177

[coder.rosebrum@yahoo.com]

Patient's visit denied by MCR for "PR-177: Patient has not met the required eligibility requirements".
Eligibility shows patient's coverage (QMB) was active at the time of service; any suggestions on how to resolve this issue?
I don't understand this, so I don't know how to explain it to the patient. Thanks!

 

[SharonCollachi]

Usually there is more than one denial code. Were there any others?

 

[suki_26]

worse case scenario, contact Medicare customer service. They may not always be nice but they should be able to explain why it was denied. Even they can send out an incorrect denial from time to time so I usually like to go directly to the horses mouth.

 

[Nelle808]

I had the same denial. When I called Medicare the rep. stated patient was ineligible on date of service due to one of the following incarceration, deportation or unlawful citizenship she could not tell me which of course (HIPAA), need to verify with patient.