How To Fix Remark Code M322 (RARC) | Common Reasons, Next Steps & How To Avoid It
Remark Code N105 means that the claim or service has been misdirected for an RRB beneficiary. In order to resolve this issue, paper claims should be submitted to the RRB carrier, Palmetto GBA, at the following address: P.O. Box 10066, Augusta, GA 30999. For electronic claims processing, RRB EDI information can be obtained by calling 888-355-9165.
1. Description
Remark Code N105 indicates that the claim or service has been misdirected for an RRB beneficiary. The official description states: ‘This is a misdirected claim/service for an RRB beneficiary.’ This remark code is used to inform healthcare providers and insurance companies that the claim or service needs to be submitted to the appropriate RRB carrier for processing.
2. Common Reasons
- Incorrect submission: The claim or service may have been submitted to the wrong carrier or entity, leading to the misdirection.
- Lack of awareness: Healthcare providers may not be familiar with the specific requirements for RRB beneficiaries and inadvertently submit claims or services to the wrong entity.
- System errors: Technical issues or errors within the claims processing system can result in misdirected claims or services.
3. Next Steps
- Submit paper claims to the RRB carrier: To resolve Remark Code N105, healthcare providers should submit paper claims to the RRB carrier, Palmetto GBA, at the following address: P.O. Box 10066, Augusta, GA 30999.
- Obtain RRB EDI information for electronic claims processing: For electronic claims processing, healthcare providers should contact the RRB carrier at 888-355-9165 to obtain the necessary RRB EDI information.
4. How To Avoid It
- Ensure correct carrier submission: Healthcare providers should verify the correct carrier or entity for RRB beneficiaries and submit claims or services accordingly.
- Stay updated on RRB requirements: It is important for healthcare providers to stay informed about the specific requirements and guidelines for RRB beneficiaries to avoid misdirected claims or services.
- Double-check claims before submission: Healthcare providers should review claims or services before submission to ensure accuracy and prevent misdirection.
5. Example Cases
- Case 1: A claim for an RRB beneficiary is denied with Remark Code N105 because it was submitted to the wrong carrier. The healthcare provider subsequently resubmits the claim to the correct RRB carrier, resulting in successful processing.
- Case 2: A service provided to an RRB beneficiary is misdirected, leading to a delay in processing. The healthcare provider contacts the RRB carrier, obtains the necessary information for electronic claims processing, and submits the service electronically, resolving the issue.
Source: Remittance Advice Remark Codes
