How To Fix Remark Code M1079 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N884 means that the No Surprises Act may apply to the claim and the payer should be contacted for instructions on how to submit information regarding whether or not the item or service was furnished during a patient visit to a participating facility. This code is important for healthcare providers to understand as it relates to compliance with the No Surprises Act and ensuring proper billing and reimbursement.

1. Description

Remark Code N884 indicates that the No Surprises Act may apply to the claim. The official description states: ‘Alert: The No Surprises Act may apply to this claim. Please contact payer for instructions on how to submit information regarding whether or not the item or service was furnished during a patient visit to a participating facility.’ This code serves as a reminder to healthcare providers to be aware of the No Surprises Act and its implications for billing and reimbursement.

2. Common Reasons

1. Claim submitted without required information: Healthcare providers may fail to include the necessary information regarding whether or not the item or service was furnished during a patient visit to a participating facility.
2. Lack of understanding of the No Surprises Act: Healthcare providers may not be familiar with the provisions of the No Surprises Act and how it impacts their billing practices.
3. Inadequate communication with payers: Healthcare providers may not proactively reach out to payers to obtain instructions on how to submit the required information.

3. Next Steps

1. Contact the payer for instructions: Healthcare providers should reach out to the payer to obtain specific instructions on how to submit the required information regarding whether or not the item or service was furnished during a patient visit to a participating facility.
2. Ensure accurate and complete documentation: Healthcare providers should ensure that their documentation clearly indicates whether or not the item or service was furnished during a patient visit to a participating facility.
3. Review and understand the No Surprises Act: Healthcare providers should familiarize themselves with the provisions of the No Surprises Act to ensure compliance with its requirements.

4. How To Avoid It

1. Stay updated on healthcare regulations: Healthcare providers should stay informed about changes in healthcare regulations, such as the No Surprises Act, to ensure compliance.
2. Communicate with payers: Healthcare providers should establish open lines of communication with payers to understand their specific requirements and instructions.
3. Document accurately and thoroughly: Healthcare providers should ensure that their documentation accurately reflects whether or not the item or service was furnished during a patient visit to a participating facility.

5. Example Cases

1. Case 1: A claim is denied because the healthcare provider failed to submit the required information regarding whether or not the item or service was furnished during a patient visit to a participating facility. This highlights the importance of understanding and complying with the No Surprises Act.
2. Case 2: A claim is adjusted because the healthcare provider communicated with the payer and submitted the necessary information as instructed. This demonstrates the importance of proactive communication with payers to ensure compliance with the No Surprises Act.

Source: Remittance Advice Remark Codes