How To Fix Remark Code M981 (RARC) | Common Reasons, Next Steps & How To Avoid It
Remark Code N783 means that the patient is a Medicaid/Qualified Medicare Beneficiary and there is a need to review the records for any wrongfully collected copayment. This code is used to alert healthcare providers to check their records and potentially bill the copayment amount to a subsequent payer.
1. Description
Remark Code N783 is an alert code that indicates the patient is a Medicaid/Qualified Medicare Beneficiary. The official description states: ‘Alert: Patient is a Medicaid/Qualified Medicare Beneficiary. Review your records for any wrongfully collected copayment. This amount may be billed to a subsequent payer.’ This code serves as a reminder to healthcare providers to review their records and ensure that any copayments collected from the patient were appropriate.
2. Common Reasons
- Wrongfully collected copayment: This remark code may be triggered if a copayment was collected from a patient who is a Medicaid/Qualified Medicare Beneficiary. Medicaid and Qualified Medicare Beneficiaries are typically exempt from copayments, so it is important to review the records and rectify any errors.
3. Next Steps
- Review records for wrongfully collected copayments: Healthcare providers should carefully review their records to identify any copayments that were collected from Medicaid/Qualified Medicare Beneficiaries.
- Verify patient’s Medicaid/Qualified Medicare Beneficiary status: Confirm the patient’s eligibility for exemption from copayments by checking their Medicaid or Medicare status.
- Bill copayment amount to a subsequent payer: If it is determined that a copayment was wrongfully collected, the amount can be billed to a subsequent payer, such as a secondary insurance provider.
4. How To Avoid It
- Verify patient’s Medicaid/Qualified Medicare Beneficiary status: Before collecting any copayments, healthcare providers should verify the patient’s eligibility for exemption from copayments.
- Educate staff on copayment policies: Ensure that all staff members are aware of the copayment policies for Medicaid/Qualified Medicare Beneficiaries and understand the proper procedures for collecting copayments.
- Regularly review records for errors: Conduct regular audits of patient records to identify any errors in copayment collection and take appropriate actions to rectify them.
5. Example Cases
- Case 1: A healthcare provider realizes that they have been collecting copayments from a patient who is a Medicaid beneficiary. They review their records, identify the wrongfully collected copayments, and bill the amount to the patient’s secondary insurance provider.
- Case 2: During an audit, it is discovered that a healthcare provider has been collecting copayments from several Qualified Medicare Beneficiaries. They rectify the error by refunding the copayments and updating their procedures to ensure proper exemption from copayments for eligible patients.
Source: Remittance Advice Remark Codes
