Thank you for this low-level overview of CAS and Remark Codes, as well as inclusion of the six alpha prefixes. While I have been working with these codes for decades, I shared this video's link with my Revenue Integrity Team here at Beth Israel Lahey Clinic in Burlington, Massachusetts. Their exposure to working denials has recently increased.
Wow! Thank you so much! Unfortunately, denials seem to be growing everywhere as insurances keep “changing the rules.” It’s unfortunate, but great to be prepared.
Can you please explain what this remark is referring to: "Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present."
Hi there, thank you for watching! It’s stating that the code is not covered under the patient’s plan for whatever reason. I’m guessing it gave you CARC 96, but there should also be a remark code (RARC) accompanying it as well for more info. Sometimes you have to call the insurance to find out exactly why the CPT is not covered if they keep it vague. There are multiple reasons why you could get this code, but sometimes if you find the reason, you can correct the claim to resubmit. I hope this helps!
Thank you for this low-level overview of CAS and Remark Codes, as well as inclusion of the six alpha prefixes. While I have been working with these codes for decades, I shared this video's link with my Revenue Integrity Team here at Beth Israel Lahey Clinic in Burlington, Massachusetts. Their exposure to working denials has recently increased.
Wow! Thank you so much! Unfortunately, denials seem to be growing everywhere as insurances keep “changing the rules.” It’s unfortunate, but great to be prepared.
Can you please explain what this remark is referring to: "Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present."
Hi there, thank you for watching! It’s stating that the code is not covered under the patient’s plan for whatever reason. I’m guessing it gave you CARC 96, but there should also be a remark code (RARC) accompanying it as well for more info. Sometimes you have to call the insurance to find out exactly why the CPT is not covered if they keep it vague. There are multiple reasons why you could get this code, but sometimes if you find the reason, you can correct the claim to resubmit. I hope this helps!
Thank you so much. I will call and check into it.@@navigatingthebusinessofmed8251