How To Fix Remark Code M966 (RARC) | Common Reasons, Next Steps & How To Avoid It

Remark Code N768 means that there is an incomplete or invalid initial evaluation report. This code is used to indicate the reason for denial or adjustment of a claim related to the initial evaluation report. It is important to address this remark code to ensure accurate billing and proper patient care.

1. Description

Remark Code N768 indicates that the initial evaluation report is incomplete or invalid. The official description states: ‘Incomplete/invalid initial evaluation report.’ The initial evaluation report is a crucial document that provides essential information about a patient’s condition, diagnosis, and treatment plan. It is important to ensure that this report is complete and accurate to support proper billing and effective patient care.

2. Common Reasons

1. Incomplete initial evaluation report: This may occur when essential information is missing or not documented properly in the report.
2. Invalid initial evaluation report: An initial evaluation report may be considered invalid if it does not meet the required standards or guidelines set by regulatory bodies or insurance companies.
3. Lack of supporting documentation: Insufficient or missing supporting documentation can lead to an incomplete or invalid initial evaluation report.
4. Errors or inaccuracies in the initial evaluation report: Mistakes or inaccuracies in the report can render it incomplete or invalid.

3. Next Steps

1. Review the initial evaluation report: Carefully examine the report to identify any missing or inaccurate information.
2. Obtain any missing documentation: Contact the healthcare provider or relevant parties to obtain any missing supporting documentation.
3. Correct errors or inaccuracies: If there are errors or inaccuracies in the report, work with the healthcare provider to correct them and ensure the report is complete and valid.
4. Resubmit the claim with the updated initial evaluation report: Once the necessary steps have been taken to address the incomplete or invalid report, resubmit the claim with the updated documentation.

4. How To Avoid It

1. Ensure thorough documentation: Healthcare providers should ensure that all relevant information is documented accurately and completely in the initial evaluation report.
2. Follow guidelines and standards: Adhere to the guidelines and standards set by regulatory bodies or insurance companies when preparing the initial evaluation report.
3. Double-check for errors or inaccuracies: Review the report for any errors or inaccuracies before submitting it.
4. Provide supporting documentation: Include all necessary supporting documentation to validate the information in the initial evaluation report.

5. Example Cases

1. Case 1: A claim is denied because the initial evaluation report does not include the patient’s medical history, making it incomplete. This highlights the importance of thorough documentation.
2. Case 2: A claim adjustment occurs because the initial evaluation report does not meet the required standards set by the insurance company. This emphasizes the need to follow guidelines and standards.

Source: Remittance Advice Remark Codes