How To Fix Remark Code M396 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N185 means that the claim or service should not be resubmitted. This code is used to alert healthcare providers and insurance companies that the claim or service has already been processed and should not be resubmitted for payment.

1. Description

Remark Code N185 indicates that the claim or service should not be resubmitted. The official description states: ‘Alert: Do not resubmit this claim/service.’ This code is typically used when a claim or service has already been processed and further resubmission is unnecessary.

2. Common Reasons

1. The claim or service has already been processed: This could be due to a variety of reasons, such as duplicate submissions, incorrect billing information, or previous payment.
2. The claim or service has been denied or adjusted: If a claim or service has already been denied or adjusted, resubmitting it without addressing the reason for denial or adjustment will not result in payment.
3. The claim or service is outside the allowable time frame: Some claims or services have specific time limits for submission, and resubmitting them after the deadline will not be accepted.

3. Next Steps

1. Review the reason for the alert: Understand why the claim or service should not be resubmitted and address any underlying issues.
2. Correct any errors or issues: If the claim or service was denied or adjusted, identify and rectify the problem before resubmitting.
3. Seek clarification if needed: If the reason for the alert is unclear, contact the insurance company or relevant authority for further guidance.

4. How To Avoid It

1. Ensure accurate and complete billing: Double-check all billing information to minimize the chances of errors or duplicate submissions.
2. Address claim denials or adjustments promptly: If a claim is denied or adjusted, promptly investigate and resolve the issue before resubmitting.
3. Adhere to submission deadlines: Familiarize yourself with the specific time frames for claim or service submission and ensure compliance.

5. Example Cases

1. Case 1: A claim is denied due to incorrect billing information. The provider resubmits the claim without correcting the error, resulting in the same denial and the N185 remark code.
2. Case 2: A service is adjusted because it was not medically necessary. The provider resubmits the same service without providing additional documentation to support its necessity, resulting in the N185 remark code.

Source: Remittance Advice Remark Codes