How To Fix Remark Code M1068 (RARC) | Common Reasons, Next Steps & How To Avoid It
Remark Code N873 means that the final payment was calculated based on an All-Payer Model Agreement, in accordance with the No Surprises Act. This code serves as an alert to healthcare providers and insurance companies that the payment calculation for a particular claim was determined using the guidelines outlined in the All-Payer Model Agreement.
1. Description
Remark Code N873 indicates that the final payment for a claim was calculated based on an All-Payer Model Agreement, in accordance with the No Surprises Act. The official description states: ‘Alert: This final payment was calculated based on an All-Payer Model Agreement, in accordance with the No Surprises Act.’ This code is used to inform healthcare providers and insurance companies that the payment calculation for the claim in question was determined using the guidelines established in the All-Payer Model Agreement.
2. Common Reasons
- Implementation of the All-Payer Model Agreement: The All-Payer Model Agreement is a payment model that aims to standardize payment calculations across different payers. Remark Code N873 may be used when the final payment for a claim is determined based on this agreement.
- Compliance with the No Surprises Act: The No Surprises Act is a federal law that protects patients from surprise medical bills. Remark Code N873 may be utilized to indicate that the payment calculation for a claim adheres to the requirements outlined in this act.
3. Next Steps
- Review the All-Payer Model Agreement: Healthcare providers and insurance companies should familiarize themselves with the details of the All-Payer Model Agreement to understand how payment calculations are determined.
- Ensure compliance with the No Surprises Act: It is crucial for healthcare providers and insurance companies to follow the guidelines set forth in the No Surprises Act to protect patients from unexpected medical bills.
4. How To Avoid It
- Stay updated on payment models and agreements: Healthcare providers and insurance companies should regularly stay informed about any changes or updates to payment models, such as the All-Payer Model Agreement.
- Adhere to the requirements of the No Surprises Act: By following the guidelines outlined in the No Surprises Act, healthcare providers and insurance companies can ensure that payment calculations are in compliance with the law.
5. Example Cases
- Case 1: A healthcare provider receives a final payment for a claim with Remark Code N873, indicating that the payment calculation was based on the All-Payer Model Agreement, ensuring consistency across payers.
- Case 2: An insurance company processes a claim with Remark Code N873, alerting the healthcare provider that the payment calculation adheres to the requirements of the No Surprises Act, protecting the patient from surprise medical bills.
Source: Remittance Advice Remark Codes
