How To Fix Remark Code M712 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N507 means that the plan distance requirements have not been met. This code is used to indicate that the distance between the healthcare provider and the patient’s location does not meet the requirements set by the insurance plan. It is important for medical coders to understand this code in order to properly address any denials or adjustments related to distance requirements.

1. Description

Remark Code N507 indicates that the plan distance requirements have not been met. The official description states: ‘Plan distance requirements have not been met.’ This means that the distance between the healthcare provider and the patient’s location does not meet the specified requirements set by the insurance plan. These requirements are put in place to ensure that patients have access to appropriate healthcare services within a reasonable distance.

2. Common Reasons

1. Provider location outside of the designated service area: One common reason for Remark Code N507 is that the healthcare provider is located outside of the designated service area specified by the insurance plan. This may result in denials or adjustments to claims.
2. Distance exceeds the maximum allowable limit: Another reason for this remark code is that the distance between the healthcare provider and the patient’s location exceeds the maximum allowable limit set by the insurance plan. This can occur when patients seek care from providers who are located far away.
3. Incorrect address or location information: Sometimes, the incorrect address or location information may be provided, leading to the plan distance requirements not being met. It is important to ensure that accurate address and location details are provided to avoid this issue.

3. Next Steps

1. Contact the insurance plan for clarification: If Remark Code N507 is received, it is advisable to contact the insurance plan to understand the specific distance requirements and any potential options for resolution.
2. Verify the patient’s address and location information: Double-checking the patient’s address and location information is crucial to ensure accuracy and compliance with the plan’s distance requirements.
3. Explore alternative healthcare providers: If the current healthcare provider does not meet the plan’s distance requirements, it may be necessary to find alternative providers within the designated service area.

4. How To Avoid It

1. Review the insurance plan’s distance requirements: Familiarize yourself with the specific distance requirements set by the insurance plan to ensure compliance.
2. Verify the patient’s location before providing services: Before providing any services, confirm that the patient’s location falls within the designated service area specified by the insurance plan.
3. Update address and location information as needed: Regularly update and maintain accurate address and location information for patients to avoid any issues related to distance requirements.

5. Example Cases

1. Case 1: A claim is denied because the healthcare provider is located outside of the designated service area specified by the insurance plan, resulting in Remark Code N507.
2. Case 2: A claim adjustment occurs because the distance between the healthcare provider and the patient’s location exceeds the maximum allowable limit set by the insurance plan, triggering Remark Code N507.

Source: Remittance Advice Remark Codes