How To Fix Remark Code M41 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code M47 means that there is a missing, incomplete, or invalid Payer Claim Control Number. This code is often used by healthcare providers and insurance companies to indicate the reason for denial or adjustment of a claim related to the control number associated with the payer.

1. Description

Remark Code M47 indicates that there is a missing, incomplete, or invalid Payer Claim Control Number. The official description states: ‘Missing/incomplete/invalid Payer Claim Control Number. Other terms exist for this element including, but not limited to, Internal Control Number (ICN), Claim Control Number (CCN), Document Control Number (DCN).’ The Payer Claim Control Number is a unique identifier assigned to each claim by the payer, and it is crucial for accurate processing and tracking of claims.

2. Common Reasons

1. The Payer Claim Control Number was not provided: This may occur if the claim was submitted without including the necessary control number or if the control number was accidentally omitted.
2. The Payer Claim Control Number is incomplete: In some cases, the control number may be partially entered or contain errors, making it invalid or incomplete.
3. The Payer Claim Control Number is invalid: This can happen if the control number does not match the format or requirements specified by the payer.

3. Next Steps

1. Contact the payer for clarification: If the Payer Claim Control Number is missing or incomplete, reach out to the payer to obtain the correct information or clarification on the requirements.
2. Verify the accuracy of the control number: Double-check the control number entered on the claim to ensure it matches the format and requirements specified by the payer.
3. Resubmit the claim with the correct Payer Claim Control Number: If the control number was missing or incorrect, correct the error and resubmit the claim with the accurate information.

4. How To Avoid It

1. Ensure the Payer Claim Control Number is included: When submitting a claim, make sure to include the correct Payer Claim Control Number as specified by the payer.
2. Double-check the accuracy of the control number: Before submitting the claim, verify that the control number is entered correctly and matches the format required by the payer.
3. Follow payer guidelines: Familiarize yourself with the specific requirements and guidelines provided by the payer regarding the Payer Claim Control Number.

5. Example Cases

1. Case 1: A claim is denied because the Payer Claim Control Number was missing, highlighting the importance of including this information for accurate claim processing.
2. Case 2: A claim adjustment occurs due to an invalid Payer Claim Control Number, emphasizing the need to ensure the control number meets the specified requirements.

Source: Remittance Advice Remark Codes