Remark code N521 is an alert indicating a discrepancy between the provider details submitted and those on record.
Remark code N521 indicates a discrepancy between the provider details submitted with the claim and the provider information on file in the payer's system. This mismatch may pertain to data elements such as the provider's name, tax identification number, or address. To resolve this issue, it's essential to verify and update the provider information to ensure it matches what is stored in the payer's system.
Common causes of code N521 are incorrect or outdated provider details submitted on the claim, discrepancies in the provider's name, address, or tax identification number between the claim form and the payer's records, and errors in the provider's National Provider Identifier (NPI) or other credentialing information as recorded in the payer's system. Additionally, this code can be triggered by changes in the provider's information that were not properly communicated to the insurance company or by data entry errors when the provider's information was initially stored in the payer's system.
Ways to mitigate code N521 include ensuring that all provider information submitted on claims matches exactly with the information on file with the payer. Regularly review and update the provider's details in the payer's system, including name, address, tax ID, and NPI number. Before submitting claims, use a pre-claim verification process to check for discrepancies in provider information. Implement a system for double-checking the accuracy of provider details on claims forms, possibly through automated software that flags mismatches before submission. Engage in ongoing communication with payers to promptly address any changes in provider information and confirm that updates are reflected in their systems. Additionally, training staff on the importance of accurate data entry and keeping them informed about any changes in provider information can help prevent this issue.
The steps to address code N521 involve a multi-faceted approach to ensure the submitted provider information aligns with what is stored in the payer's system. Initially, conduct a thorough review of the provider information submitted with the claim, including but not limited to, the provider's name, address, tax identification number (TIN), and National Provider Identifier (NPI). Cross-reference this information with what is currently on file with the payer by accessing the payer's provider portal or contacting their provider relations department directly.
If discrepancies are identified, update the provider's information in your billing system to reflect the correct details. In cases where the information on file with the payer is outdated or incorrect, submit the necessary documentation to the payer to update their records. This may include a W-9 form for TIN updates, or a CMS-855 form for changes to the provider's name, address, or NPI.
After ensuring both the billing system and the payer's records are updated and aligned, resubmit the claim with the corrected provider information. To prevent future occurrences of code N521, implement a routine verification process where provider information is regularly checked and updated in both the billing system and with all payers. This proactive approach can significantly reduce the likelihood of mismatched provider information and improve the overall efficiency of the claims submission process.
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