How To Fix Remark Code M238 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N8 means that a crossover claim was denied by the previous payer because complete claim data was not forwarded. This code is used to indicate that the claim needs to be resubmitted to the current payer with adequate data for adjudication.

1. Description

Remark Code N8 indicates that a crossover claim was denied by the previous payer due to incomplete claim data not being forwarded. The official description states: ‘Crossover claim denied by previous payer and complete claim data not forwarded. Resubmit this claim to this payer to provide adequate data for adjudication.’ This remark code highlights the importance of ensuring all necessary claim data is included when submitting a crossover claim.

2. Common Reasons

1. Incomplete claim data not forwarded: This may occur due to errors or omissions when transferring claim information from the previous payer to the current payer.
2. Missing or inaccurate patient information: Incomplete or incorrect patient information can lead to claim denials or delays in adjudication.
3. Failure to include supporting documentation: Additional documentation may be required to support the crossover claim, such as explanation of benefits (EOB) from the previous payer.
4. Incorrect coding or billing information: Errors in coding or billing can result in claim denials or adjustments.

3. Next Steps

1. Review the denial or rejection notice: Carefully examine the communication from the previous payer to understand the specific reasons for the denial.
2. Collect and submit complete claim data: Ensure all necessary claim data, including patient information, supporting documentation, and accurate coding, is included when resubmitting the claim.
3. Coordinate with the previous payer: If there are any questions or concerns regarding the denial, reach out to the previous payer for clarification or assistance in obtaining the required data.

4. How To Avoid It

1. Ensure complete and accurate claim data is forwarded: Double-check that all necessary claim information is transferred from the previous payer to the current payer.
2. Verify patient information: Confirm that patient details, such as name, date of birth, and insurance information, are accurate and up to date.
3. Include all required supporting documentation: Review the crossover claim requirements and include any necessary documentation, such as EOBs or prior authorization forms.
4. Double-check coding and billing: Ensure that the coding and billing information is accurate and in compliance with the current payer’s guidelines.

5. Example Cases

1. Case 1: A crossover claim is denied because the previous payer did not forward complete claim data, emphasizing the need for accurate data transfer.
2. Case 2: A claim adjustment occurs due to missing supporting documentation in the crossover claim, highlighting the importance of including all required documentation.

Source: Remittance Advice Remark Codes