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Clarity Flow
Accurate patient cost estimate software that stimulates upfront payments and complies with price transparency regulations.
RevFind
Underpayment detection and contract optimization software that ingests your contract terms and identifies opportunities for net revenue uplift when payers stiff you.
Use Cases
Detect Underpayments
Identify revenue opportunities from payer underpayments down to the claim level.
Increase Upfront Collections
Avoid write-offs by collecting from patients earlier in the AR cycle.
Comply with Good Faith Estimates
Automate creation and delivery of accurate patient estimates to adhere to transparency rules.
Evaluate Contract Performance
Measure and compare managed care contract performance for better negotiation outcomes.
Optimize Your Chargemaster
Correct chargemaster rates that fall short of contracted rates to maximize revenue.
Track Underpayment Recovery
Uncover which payers respond most quickly and fully to reimbursement demands.
Manage Denials
Jumpstart your appeals and denials prevention processes by automating denials management.
Model Potential Contract Rate Changes
Model the impact of contract proposals on revenue during negotiations with payers.
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Learn the latest on healthcare transparency policy and trends in revenue cycle management.
Case Studies
Read real stories of how providers have achieved success with MD Clarity.
Guides
Get in-depth knowledge through our comprehensive handbooks on specific regulations and revenue cycle applications.
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Denial Code (RARC) List
Overwhelmed by RARCs? Get up to speed with our list of remark codes.
RARC #
Remittance Advice Remark Code Description
N354
Remark code N354 indicates an issue with a claim due to an incomplete or invalid invoice, requiring correction for processing.
N355
Remark code N355 is an alert indicating exceptions to refund requirements under specific conditions related to service payment denials.
N356
Remark code N356 is an alert that a service isn't covered if done with or after a non-covered procedure.
N357
Remark code N357 indicates that the necessary time gap between related healthcare services or supplies was not adhered to.
N358
Remark code N358 alerts healthcare providers that a decision may be reconsidered with submission of further documentation as specified.
N359
Remark code N359 is an alert indicating the patient's height information is missing, incomplete, or invalid in the claim.
N36
Remark code N36 indicates that a claim must comply with the primary insurer's rules before secondary payment consideration.
N360
Remark code N360 is an alert indicating benefits were estimated without coordination of benefits. Submit primary payer info with the secondary claim.
N362
Remark code N362 indicates that the submitted days or units of service surpass the maximum allowed by the payer.
N363
Remark code N363 alerts healthcare providers about upcoming policy/procedure changes that may impact claim determinations.
N364
Remark code N364 indicates that, per the agreement, deductible and/or coinsurance amounts must be waived by the provider.
N366
Remark code N366 is a notice that a claim was denied due to missing information, but can be reopened if the required details are submitted within one year.
N367
Remark code N367 indicates a claim has been sent to a Consumer Spending Account processor, such as an FSA or HSA, for review.
N368
Remark code N368 is an instruction for providers to appeal a decision on a previously adjudicated claim for resolution.
N369
Remark code N369 indicates a processed claim is deficient as per state legislation/regulation, requiring further action.
N37
Remark code N37 indicates a claim issue due to a missing, incomplete, or invalid tooth number or letter on dental claims.
N370
Remark code N370 indicates billing surpasses the rental months authorized by the insurance, requiring review or adjustment.
N371
Remark code N371 indicates that the equipment's ownership must be transferred to the patient.
N372
Remark code N372 indicates that only charges deemed reasonable and necessary for maintenance or service are covered by insurance.
N373
Remark code N373 indicates a refund to the payer who incorrectly paid services as primary, due to another payer being identified as primary.
N374
Remark code N374 indicates Medicare Part A benefits are depleted; a Part B Remittance Advice is now necessary for processing.
N375
Remark code N375 indicates a claim issue due to missing or invalid information needed to verify dependent eligibility.
N376
Remark code N376 indicates when a patient is on active military duty, making TRICARE the primary insurance coverage.
N377
Remark code N377 indicates payment adjustments were made based on a processed replacement claim.
N378
Remark code N378 indicates a claim issue due to a missing, incomplete, or invalid prescription quantity on the submission.
N379
Remark code N379 indicates a discrepancy between claim and line level information, requiring review for accurate processing.
N380
Remark code N380 indicates the original claim was processed; providers should submit a corrected claim for further review.
N381
Remark code N381 is an alert to review contractual agreements for specific billing and payment rules related to charges.
N382
Remark code N382 is an alert for missing or incorrect patient ID details in healthcare billing documents.
N383
Remark code N383 is an explanation for services not covered due to being considered cosmetic by the insurer.
N384
Remark code N384 is an alert that the claimed service for a previously removed body part/tooth cannot be processed.
N385
Remark code N385 indicates a claim issue due to untimely admission notification as per the plan's procedures.
N386
Remark code N386 indicates a decision based on a National Coverage Determination (NCD), outlining coverage for specific services or items.
N387
Remark code N387 is a notification to submit the claim to the patient's secondary insurer for possible supplemental benefits payment.
N388
Remark code N388 indicates a claim issue due to a missing, incomplete, or invalid prescription number.
N389
Remark code N389 is an alert indicating a duplicate prescription number has been submitted in a claim.
N39
Remark code N39 indicates an issue with billing where the dental procedure code does not match the specified tooth number/letter.
N390
Remark code N390 indicates that the service or report provided cannot be billed as a separate charge.
N391
Remark code N391 indicates a claim denial due to missing emergency department records, requiring submission for processing.
N392
Remark code N392 is an alert indicating that emergency department records are incomplete or invalid, requiring attention.
N393
Remark code N393 indicates a claim denial due to the absence of required progress notes or reports.
N394
Remark code N394 is an alert indicating the submission of incomplete or invalid progress notes or reports in billing.
N395
Remark code N395 is an alert indicating a claim's denial due to the absence of the required laboratory report.
N396
Remark code N396 is an alert indicating an incomplete or invalid lab report, requiring review for accurate healthcare billing.
N397
Remark code N397 indicates benefits are denied for services/items not fully provided or delivered.
N398
Remark code N398 is an alert indicating a claim's denial due to a missing elective consent form, requiring action.
N399
Remark code N399 indicates an issue with the elective consent form, either due to it being incomplete or invalid.
N4
Remark code N4 indicates an EOB from prior insurance is missing, incomplete, or invalid, requiring action for claim processing.
N40
Remark code N40 indicates a claim denial due to missing radiology films or images required for processing.
N400
Remark code N400 indicates that providers capable of electronic submissions should file claims digitally for efficiency.
N401
Remark code N401 is an alert indicating the absence of required periodontal charting in a claim submission.
N402
Remark code N402 is an alert for healthcare providers about incomplete or invalid periodontal charting in billing documents.
N403
Remark code N403 indicates a claim was denied due to the absence of necessary facility certification documentation.
N404
Remark code N404 is an alert indicating the facility's certification is either incomplete or invalid, requiring attention.
N405
Remark code N405 is an explanation that a service is covered only if the donor's insurers do not cover it.
N406
Remark code N406 indicates a service is covered only if the recipient's insurers do not offer coverage for this specific service.
N407
Remark code N407 indicates that the sender is not authorized to submit claims in the specified transmission format.
N408
Remark code N408 is an explanation that the current insurer does not cover deductibles charged by another payer.
N409
Remark code N409 indicates a service linked to an accidental injury is not covered unless it's within a certain time from the accident date.
N410
Remark code N410 is an indication that a service is not covered unless there is a change in the prescription.
N411
Remark code N411 indicates a service is permitted once every 6 months, highlighting claim limitations for healthcare providers.
N412
Remark code N412 indicates a limit of 2 allowances for this service within a 12-month period, guiding billing adjustments.
N413
Remark code N413 is an alert indicating a service is covered twice in a benefit year, guiding billing adjustments.
N414
Remark code N414 indicates a limit of 4 allowances for this service within a 12-month period, guiding billing adjustments.
N415
Remark code N415 indicates a limitation: the service is permitted only once within an 18-month timeframe.
N416
Remark code N416 indicates a limitation: the service is permitted only once every three years.
N417
Remark code N417 is an alert that a service is approved only once every 5 years, indicating billing limitations.
N418
Remark code N418 is an alert that a claim was sent incorrectly. Review the payer's submission guidelines for proper routing.
N419
Remark code N419 is an explanation for claim adjustments due to payer's retroactive rate changes.
N42
Remark code N42 indicates a claim denial due to a missing mental health assessment in the documentation.
N420
Remark code N420 indicates a claim payment adjustment due to a retroactive Coordination of Benefits or Third Party Liability Recovery.
N421
Remark code N421 indicates a claim payment adjustment following a payer's review organization decision for retroactive changes.
N422
Remark code N422 indicates a claim payment adjustment due to a retroactive change from a payer's contract incentive program.
N423
Remark code N423 indicates a claim payment adjustment by the payer, due to a retroactive change from a non-standard program.
N424
Remark code N424 indicates a payment denial because the patient's residence is outside the required geographic area.
N425
Remark code N425 indicates a service is not covered by insurance as it's legally excluded from coverage.
N426
Remark code N426 is an explanation for denied insurance claims due to self-administered medication lacking coverage.
N427
Remark code N427 indicates payment for eyeglasses or contact lenses is approved only post-cataract surgery.
N428
Remark code N428 is an explanation for services not covered at the specified location.
N429
Remark code N429 is an indicator that a service is not covered by insurance when it is deemed routine.
N43
Remark code N43 indicates that the patient's allotted bed hold or leave days have been surpassed in a healthcare facility.
N430
Remark code N430 indicates that the procedure code does not match the number of units billed, suggesting a billing error.
N431
Remark code N431 indicates a service isn't covered when paired with the specific procedure performed.
N432
Remark code N432 is an alert indicating an adjustment made due to a Recovery Audit finding in healthcare billing.
N433
Remark code N433 is a notification to resubmit a claim with the provider's exclusive National Provider Identifier (NPI) only.
N434
Remark code N434 is an alert for missing or invalid Present on Admission indicators in healthcare claims documentation.
N435
Remark code N435 is an alert that claims exceed the approved number/frequency within a time period without proper documentation.
N436
Remark code N436 indicates that the injury claim is pending acceptance, yet a compulsory medical payment has been processed.
N437
Remark code N437 indicates that if the injury claim is accepted, the charges in question will be reconsidered for payment.
N438
Remark code N438 is an alert that only paper claims are accepted in this specific jurisdiction, impacting claim processing.
N439
Remark code N439 is an alert indicating the absence of required anesthesia physical status report/indicators in a claim.
N440
Remark code N440 is an alert for healthcare providers about incomplete or invalid anesthesia status reports.
N441
Remark code N441 indicates that the insurance does not cover missed or cancelled appointments.
N442
Remark code N442 is an indication that payment was adjusted according to an alternative fee schedule.
N443
Remark code N443 is an alert for missing or incorrect total time or session start/end times on a claim submission.
N444
Remark code N444 is an alert indicating a facility hasn't filed the Election for High Cost Outlier form with the Division of Workers' Compensation.
N445
Remark code N445 indicates a claim denial due to missing documentation for the actual cost or paid amount.
N446
Remark code N446 is an alert indicating missing or incorrect documentation for the actual cost or payment amount.
N447
Remark code N447 indicates payment adjustment due to lack of required documentation for brand-name medication, opting for a generic equivalent.
N448
Remark code N448 indicates a drug, service, or supply not covered under the fee schedule or contracted fee arrangements.
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