Denial Code 271 means that prior contractual reductions related to a current periodic payment as part of a contractual payment schedule have been previously reported. This denial code is used in conjunction with Group Code OA. In this article, we will provide a description of denial code 271, common reasons for its occurrence, next steps to resolve the denial, tips on how to avoid it in the future, and examples of denial code 271 cases.
2. Description
Denial Code 271 is a specific Claim Adjustment Reason Code (CARC) that indicates prior contractual reductions related to a current periodic payment as part of a contractual payment schedule have already been reported. This denial code is typically used in conjunction with Group Code OA. Essentially, it means that the claim has been denied because the payment for the current payment period has already been accounted for in a previous report.
2. Common Reasons
The most common reasons for denial code 271 are:
- Double Reporting: One common reason for denial code 271 is when the same payment for a current periodic payment is reported multiple times. This could occur due to errors in the billing or reporting process, resulting in duplicate entries for the same payment.
- Incorrect Payment Schedule: Another reason for denial code 271 is when the payment schedule is not accurately reflected in the billing or reporting. This could happen if the payment schedule is not properly updated or if there are discrepancies between the scheduled payments and the reported payments.
- Failure to Account for Prior Payments: Denial code 271 may also occur if prior payments related to the current periodic payment are not properly accounted for in the billing or reporting. This could be due to oversight or errors in tracking and reporting previous payments.
3. Next Steps
To resolve denial code 271, follow these next steps:
- Review Payment Reports: Start by reviewing the payment reports to identify any instances of double reporting or discrepancies in the payment schedule. Ensure that all payments related to the current periodic payment have been accurately reported.
- Correct Reporting Errors: If any errors or discrepancies are identified, take the necessary steps to correct them. This may involve updating the billing or reporting system, adjusting payment records, or providing additional documentation to support the accurate reporting of payments.
- Communicate with Payers: Reach out to the insurance company or payer to discuss the denial and provide any necessary documentation or explanations. This communication can help clarify any misunderstandings or discrepancies and facilitate the resolution of the denial.
- Resubmit the Claim: Once the reporting errors have been corrected and any necessary communication with the payer has taken place, resubmit the claim for reconsideration. Ensure that all relevant information and documentation are included to support the accurate reporting of payments.
- Monitor Payment Reports: After resubmitting the claim, closely monitor the payment reports to ensure that the denial code 271 is no longer being applied. If the denial persists, continue to engage with the payer to address any remaining issues or discrepancies.
4. How To Avoid It
To avoid denial code 271 in the future, consider the following tips:
- Implement Robust Payment Tracking Systems: Use reliable and accurate payment tracking systems to ensure that all payments are properly recorded and reported. This can help prevent double reporting or errors in the payment schedule.
- Regularly Review Payment Reports: Regularly review payment reports to identify any discrepancies or errors in the reported payments. Promptly address any issues to avoid potential denials or complications.
- Ensure Clear Communication: Maintain open lines of communication with payers to clarify any questions or concerns regarding payment reporting. Clear communication can help prevent misunderstandings and facilitate the accurate reporting of payments.
- Train Staff on Payment Reporting Procedures: Provide comprehensive training to staff members involved in payment reporting to ensure they understand the correct procedures and protocols. This can help minimize errors and ensure accurate reporting.
5. Example Cases
Here are two examples of denial code 271:
- Example 1: A healthcare provider submits a claim for a monthly payment of $500 for a specific service. However, the payment for that month had already been reported in a previous claim, resulting in denial code 271.
- Example 2: Due to an error in the billing system, a provider mistakenly reports the same payment twice for a current periodic payment. As a result, the claim is denied with denial code 271.
