How To Fix Remark Code M820 (RARC) | Common Reasons, Next Steps & How To Avoid It
Remark Code N618 means that this claim will automatically be reprocessed if the enrollee pays their premiums. This code serves as an alert to both healthcare providers and insurance companies, indicating that the claim can be resolved if the enrollee fulfills their premium payment obligations.
1. Description
Remark Code N618 serves as an alert to healthcare providers and insurance companies that this claim will automatically be reprocessed if the enrollee pays their premiums. The official description states: ‘Alert: This claim will automatically be reprocessed if the enrollee pays their premiums.’ This remark code is designed to ensure that claims are not denied permanently due to temporary non-payment of premiums, allowing for resolution once the enrollee fulfills their financial obligations.
2. Common Reasons
- Non-payment of premiums: The most common reason for Remark Code N618 is when the enrollee fails to pay their premiums on time or at all. This can result in the claim being initially denied or adjusted.
3. Next Steps
- Communicate with the enrollee: Contact the enrollee to inform them about the non-payment of premiums and the impact it has on their claim. Provide them with the necessary information to resolve the issue.
- Verify premium payment: Once the enrollee pays their premiums, verify the payment with the insurance company to ensure that the claim can be reprocessed.
- Submit the claim for reprocessing: After confirming the premium payment, resubmit the claim for reprocessing, ensuring that all necessary documentation is included.
4. How To Avoid It
- Ensure timely premium payments: Encourage enrollees to pay their premiums on time to avoid any disruptions in claim processing.
- Provide clear communication: Educate enrollees about the importance of premium payments and the potential consequences of non-payment on their claims.
- Offer payment assistance: If an enrollee is facing financial difficulties, provide information about available payment assistance programs or options to help them fulfill their premium obligations.
5. Example Cases
- Case 1: A claim is initially denied due to non-payment of premiums. However, once the enrollee pays their premiums, the claim is automatically reprocessed, resulting in successful reimbursement.
- Case 2: An enrollee’s claim is adjusted because they failed to pay their premiums on time. After the enrollee resolves the payment issue, the claim is reprocessed, leading to a favorable outcome.
Source: Remittance Advice Remark Codes
