How To Fix Remark Code M816 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N614 means that additional information is included in the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information). This code serves as an alert to healthcare providers and insurance companies that there is additional information related to healthcare policy in the payment information section of the electronic remittance advice (ERA).

1. Description

Remark Code N614 indicates that there is additional information included in the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information). The official description states: ‘Alert: Additional information is included in the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information).’ This code is used to notify healthcare providers and insurance companies that there is important policy-related information that needs to be reviewed and considered.

2. Common Reasons

1. Incomplete or missing policy information: This may occur when the healthcare policy information is not properly entered or transmitted in the electronic remittance advice.
2. Policy changes or updates: Remark Code N614 may be used to indicate that there have been changes or updates to the healthcare policy that need to be reviewed and understood.
3. Policy-specific requirements: Certain healthcare policies may have specific requirements or guidelines that need to be followed, and Remark Code N614 can be used to alert providers to these requirements.
4. Policy-related denials or adjustments: This code may be used to indicate that a claim has been denied or adjusted based on specific policy provisions.

3. Next Steps

1. Review the 835 Healthcare Policy Identification Segment: Healthcare providers should carefully review the payment information section of the electronic remittance advice to identify any additional policy-related information.
2. Understand the policy implications: It is important to understand the impact of the policy information provided in the 835 segment on the claim or payment.
3. Contact the insurance company or payer: If there are any questions or concerns regarding the policy information, healthcare providers should reach out to the insurance company or payer for clarification.

4. How To Avoid It

1. Ensure accurate and complete policy information: Healthcare providers should double-check that all policy information is accurately entered and transmitted in the electronic remittance advice.
2. Stay updated on policy changes: It is crucial to stay informed about any changes or updates to healthcare policies that may affect claims or payments.
3. Follow policy-specific requirements: Familiarize yourself with the specific requirements or guidelines of each healthcare policy to ensure compliance.
4. Submit claims with proper documentation: Providing all necessary documentation and supporting information with claims can help avoid policy-related denials or adjustments.

5. Example Cases

1. Case 1: A claim is flagged with Remark Code N614, indicating that there is additional policy information in the 835 segment. The healthcare provider reviews the segment and discovers that a prior authorization is required for the service rendered.
2. Case 2: Remark Code N614 is used to alert the healthcare provider that the claim has been adjusted due to a change in the policy coverage for the specific procedure performed.

Source: Remittance Advice Remark Codes