How To Fix Remark Code M22 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code M23 means that an invoice is missing. This code is used to indicate that the claim or payment request is missing the necessary invoice or supporting documentation. Healthcare providers and insurance companies utilize this code to communicate the reason for denial or adjustment of a claim.

1. Description

Remark Code M23 indicates that an invoice is missing. The official description states: ‘Missing invoice.’ This means that the claim or payment request does not include the required invoice or supporting documentation. Having the necessary documentation is crucial for accurate processing and reimbursement of claims.

2. Common Reasons

1. Incomplete submission: The claim or payment request may be missing the invoice due to an oversight or error during the submission process. This can happen when the necessary documentation is not included or when there are issues with the electronic submission.
2. Lost or misplaced invoice: Sometimes, the invoice may have been misplaced or lost during the handling or processing of the claim. This can occur due to administrative errors or logistical challenges within the healthcare provider’s or insurance company’s systems.
3. Technical issues: There may be technical issues with the electronic systems used for claim submission and processing, resulting in the loss or failure to capture the invoice. This can happen due to system glitches, connectivity problems, or software errors.
4. Improper documentation: The invoice may not meet the required standards or contain the necessary information for proper processing. This can include missing details, incomplete documentation, or discrepancies in the provided information.

3. Next Steps

1. Resubmit the claim with the missing invoice: Contact the healthcare provider or insurance company to determine the specific requirements for the invoice and ensure it is included in the resubmission. This may involve obtaining a copy of the missing invoice or providing additional supporting documentation.
2. Verify the correct submission process: Review the submission guidelines and requirements to ensure that the invoice is submitted correctly. This may involve using specific forms, codes, or electronic systems for claim submission.
3. Follow up with the appropriate department: Contact the relevant department within the healthcare provider or insurance company to inquire about the status of the missing invoice and any additional steps that need to be taken.

4. How To Avoid It

1. Double-check the submission: Before submitting a claim or payment request, ensure that all required documentation, including the invoice, is included and accurate. Review the submission guidelines and requirements to avoid any oversights or errors.
2. Maintain organized records: Keep a well-organized system for storing and retrieving invoices and supporting documentation. This can include using electronic document management systems or physical filing systems to ensure easy access when needed.
3. Communicate effectively: Establish clear communication channels with the healthcare provider or insurance company to understand their specific requirements for invoice submission. This can help avoid any misunderstandings or discrepancies in the documentation.

5. Example Cases

1. Case 1: A claim for medical services is denied because the invoice was not included in the submission. The healthcare provider resubmits the claim with the missing invoice, and the claim is subsequently processed and reimbursed.
2. Case 2: A payment request for a specific procedure is adjusted because the invoice provided does not contain the necessary details for proper processing. The healthcare provider provides a revised invoice with the required information, and the payment request is successfully processed.

Source: Remittance Advice Remark Codes