Remark code N665 indicates that services from an unlicensed provider are not eligible for reimbursement.
Remark code N665 indicates that services provided by an individual who does not hold the necessary license are not eligible for reimbursement.
Common causes of code N665 are billing for services rendered by a provider who does not hold a current, valid license in the state where the services were provided, or submitting claims for a provider whose credentials have not been properly verified or updated in the payer's system.
Ways to mitigate code N665 include ensuring that all providers delivering services are properly licensed and credentialed for the state in which they are practicing. Regularly verify the status of each provider's license and credentials to catch any lapses or expirations promptly. Implement a robust onboarding process for new providers that includes thorough checks of their licensure and credentialing status before they begin seeing patients. Additionally, establish a system for continuous monitoring and education to keep providers aware of the importance of maintaining their licensure and to alert administrative staff of any upcoming renewals or required continuing education credits. This proactive approach can help prevent services being rendered by an unlicensed provider, thus avoiding this specific denial reason.
The steps to address code N665 involve several key actions to ensure compliance and reimbursement for services rendered. Initially, it's crucial to verify the licensure status of the provider in question. If the provider is indeed licensed but the information was not accurately reflected in the claim, update the provider's credentials in your billing system and resubmit the claim with the correct information. In cases where the provider is not licensed, it's necessary to reassign the billed services to a licensed provider within your practice who can legally assume responsibility for those services, if applicable and permissible under state laws and regulations. Following the reassignment, the claim should be corrected to reflect the licensed provider's information and resubmitted. Additionally, implement a routine verification process for all providers' licensure status in your practice to prevent future occurrences of this code. This may involve periodic checks against state licensing boards and updating your billing system accordingly to ensure all provider information is current and accurate.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
