Remark code N799 indicates that a claim's submitted identifier must be specific to an individual, not a group, for processing.
Remark code N799 indicates that the submitted identifier must be an individual identifier, not a group identifier.
Common causes of code N799 are submitting a billing provider's Tax Identification Number (TIN) instead of the National Provider Identifier (NPI) of the individual practitioner who performed the service, using a group NPI when payer policies require an individual NPI, or inaccurately entering the group NPI in a field designated for the individual provider's NPI. This often occurs due to misunderstandings of payer requirements or errors in electronic health record (EHR) system configurations that default to group identifiers.
Ways to mitigate code N799 include ensuring that the billing process involves a thorough review of the identifiers being used. This involves training billing staff to recognize and differentiate between individual and group identifiers. Implementing a verification step before submission can catch errors where a group identifier might have been mistakenly used instead of an individual one. Additionally, leveraging billing software that flags potential mismatches or incorrect identifier types can prevent this issue. Regular audits of billing practices can also help identify patterns that lead to this error, allowing for corrective action to be taken proactively.
The steps to address code N799 involve several key actions to ensure proper claim submission and processing. First, review the claim to identify where a group identifier was mistakenly used instead of an individual identifier. This typically involves checking the provider information section of the claim form. Once identified, correct the error by replacing the group identifier with the appropriate individual identifier, which could be the National Provider Identifier (NPI) of the specific healthcare provider who delivered the services.
Next, it's crucial to double-check the rest of the claim for any additional errors or inconsistencies that might lead to further denials or delays. This includes verifying that all other provider information is accurate and matches the individual identifier now listed.
After making the necessary corrections, resubmit the claim to the payer as soon as possible to minimize delays in payment. Keep a record of the original denial and the steps taken to correct the issue, as this documentation can be helpful if there are any questions or disputes about the claim in the future.
Finally, to prevent similar issues from occurring, consider implementing a review process for future claims that specifically checks for correct usage of individual versus group identifiers before submission. This might involve training or reminders for staff involved in the billing process about the importance of using the correct identifiers and how to distinguish between them.
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