How To Fix Remark Code M227 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code MA131 means that the physician has already been paid for services related to this demonstration claim. In order for your claim to be processed, the physician must withdraw their claim and refund the payment. This code is used to indicate the reason for denial or adjustment of a claim when the physician has already been compensated for the services rendered.

1. Description

Remark Code MA131 indicates that the physician has already received payment for services associated with this demonstration claim. The official description states: ‘Physician already paid for services in conjunction with this demonstration claim. You must have the physician withdraw that claim and refund the payment before we can process your claim.’ This remark code is used to ensure that duplicate payments are not made and to maintain the integrity of the billing process.

2. Common Reasons

1. Duplicate submission of the claim: This may occur when the same claim is submitted multiple times, resulting in duplicate payments to the physician.
2. Incorrect billing: If the physician has already been compensated for the services rendered, submitting a claim for the same services again would result in an adjustment or denial.
3. Failure to withdraw the initial claim: If the physician does not withdraw the original claim and refund the payment, the subsequent claim cannot be processed.

3. Next Steps

1. Contact the physician: Reach out to the physician and inform them about the situation. Request that they withdraw the initial claim and refund the payment.
2. Provide necessary documentation: If required, provide any supporting documentation or evidence to the physician to support the need for withdrawal and refund.
3. Follow up: Regularly follow up with the physician to ensure that the withdrawal and refund process is completed in a timely manner.

4. How To Avoid It

1. Ensure accurate billing: Double-check the billing information before submitting a claim to avoid duplicate submissions.
2. Coordinate with the physician: Maintain open communication with the physician to ensure they are aware of any demonstration claims and can take appropriate action.
3. Review payment history: Regularly review payment records to identify any instances where the physician has already been compensated for services.

5. Example Cases

1. Case 1: A claim for a demonstration claim is denied because the physician has already been paid for the services rendered. The provider must contact the physician to withdraw the initial claim and refund the payment before the claim can be processed.
2. Case 2: An adjustment is made to a claim for a demonstration claim as the physician has already received payment. The provider must follow up with the physician to ensure the withdrawal and refund process is completed.

Source: Remittance Advice Remark Codes