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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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Denial Code (RARC) List
Overwhelmed by RARCs? Get up to speed with our list of remark codes.
RARC #
Remittance Advice Remark Code Description
N449
Remark code N449 is an explanation for payment adjustments based on the cost of a comparable drug, service, or supply.
N45
Remark code N45 indicates a payment adjustment based on the authorized amount for a healthcare service or procedure.
N450
Remark code N450 is an explanation that a service is covered only if done by the primary physician or their designee.
N451
Remark code N451 indicates a claim denial due to the absence of the required Admission Summary Report.
N452
Remark code N452 is an alert indicating the Admission Summary Report is incomplete or invalid, requiring attention for claim processing.
N453
Remark code N453 is an alert indicating a claim's denial due to the absence of a required consultation report.
N454
Remark code N454 is an alert indicating a claim's denial due to an incomplete or invalid consultation report.
N455
Remark code N455 is an alert indicating a claim was denied due to a missing physician order, requiring submission for processing.
N456
Remark code N456 is an alert indicating the need for a complete or valid physician order in healthcare billing.
N457
Remark code N457 is an alert indicating a claim's denial due to the absence of the required diagnostic report.
N458
Remark code N458 is an alert indicating the diagnostic report submitted is incomplete or invalid, requiring review or correction.
N459
Remark code N459 is an alert indicating a claim's rejection due to the absence of a discharge summary.
N46
Remark code N46 indicates an error due to missing, incomplete, or invalid admission hour on a healthcare claim.
N460
Remark code N460 is an alert indicating the discharge summary provided is either incomplete or invalid for processing.
N461
Remark code N461 is an alert indicating that nursing notes required for billing are missing from the documentation.
N462
Remark code N462 is an alert indicating the submission of incomplete or invalid Nursing Notes in a claim.
N463
Remark code N463 is an alert indicating a claim lacks necessary supporting documentation for processing.
N464
Remark code N464 indicates a claim has been denied due to missing or incorrect supporting documentation.
N465
Remark code N465 indicates a claim denial due to missing physical therapy notes or reports, requiring submission for processing.
N466
Remark code N466 is an alert indicating the submission of incomplete or invalid Physical Therapy Notes/Report.
N467
Remark code N467 indicates a claim denial due to the absence of required tests and analysis reports in the submission.
N468
Remark code N468 is an alert for healthcare providers about incomplete or invalid test and analysis reports in billing submissions.
N469
Remark code N469 indicates a claim/service is under appeal as per section 935 of the 2003 Medicare Modernization Act.
N47
Remark code N47 indicates a claim denial due to a conflict with another inpatient stay, requiring review.
N470
Remark code N470 indicates that the payment issued will fulfill the required medical reimbursement cap.
N471
Remark code N471 is an alert for missing or incorrect HIPPS Rate Code in healthcare billing submissions.
N472
Remark code N472 indicates that payment for the service was made to a different provider.
N473
Remark code N473 is an alert indicating a claim's denial due to the absence of required certification documentation.
N474
Remark code N474 indicates an issue with a claim due to incomplete or invalid certification documentation provided.
N475
Remark code N475 indicates a claim denial due to the absence of a completed referral form.
N476
Remark code N476 indicates an issue with a referral form, specifically that it's incomplete or invalid, requiring attention.
N477
Remark code N477 indicates that a claim was denied due to missing dental models required for processing.
N478
Remark code N478 is an alert indicating the submission of incomplete or invalid dental models in a claim.
N479
Remark code N479 is an alert indicating the absence of an Explanation of Benefits for Coordination or Medicare Secondary Payer details.
N48
Remark code N48 indicates a discrepancy between claim details and data from another insurer, requiring review.
N480
Remark code N480 indicates an incomplete or invalid Explanation of Benefits due to issues with Coordination of Benefits or Medicare Secondary Payer.
N481
Remark code N481 indicates that the claim submission lacks necessary model information for processing.
N482
Remark code N482 is an alert indicating the submission contains incomplete or invalid model information, requiring review.
N485
Remark code N485 indicates a claim denial due to the absence of required Physical Therapy Certification documentation.
N486
Remark code N486 is an alert indicating the Physical Therapy Certification submitted is incomplete or invalid.
N487
Remark code N487 indicates a claim denial due to missing certification for prosthetics or orthotics.
N488
Remark code N488 is an alert for healthcare providers about missing or incorrect certification for prosthetics or orthotics claims.
N489
Remark code N489 is an alert indicating a claim denial due to the absence of a required referral form.
N49
Remark code N49 indicates that the payer requires validation of court-ordered coverage information for claim processing.
N490
Remark code N490 indicates an issue with a referral form due to it being incomplete or invalid, requiring attention for claim processing.
N491
Remark code N491 indicates an issue with the Exclusionary Rider Condition, either missing, incomplete, or invalid.
N492
Remark code N492 indicates a provider can bill a patient if there was prior written agreement for responsibility of service charges.
N493
Remark code N493 is an alert indicating the initial injury report from the doctor is missing from the claim documentation.
N494
Remark code N494 indicates an error due to an incomplete or invalid Doctor's First Report of Injury submission.
N495
Remark code N495 is an alert indicating a claim's denial due to the absence of a required supplemental medical report.
N496
Remark code N496 is an alert indicating a submitted claim's Supplemental Medical Report is incomplete or invalid.
N497
Remark code N497 indicates a claim was denied due to a missing Medical Permanent Impairment or Disability Report.
N498
Remark code N498 is an alert for missing or incorrect Medical Permanent Impairment or Disability Report details in claims.
N499
Remark code N499 is an alert indicating the absence of a required medical legal report in the claim submission.
N5
Remark code N5 indicates that an EOB was received from a prior payer, but the claim is not found in the current payer's records.
N50
Remark code N50 indicates a claim denial due to missing, incomplete, or invalid discharge information.
N500
Remark code N500 is an alert indicating the Medical Legal Report submitted is incomplete or invalid, requiring attention.
N501
Remark code N501 is an alert indicating a vocational report is missing from the submitted documentation.
N502
Remark code N502 is an alert indicating the Vocational Report submitted is incomplete or invalid, requiring attention.
N503
Remark code N503 is an alert indicating the absence of a required Work Status Report in a healthcare claim submission.
N504
Remark code N504 is an alert indicating the Work Status Report is either incomplete or invalid, requiring attention.
N505
Remark code N505 indicates services estimated in real-time are included in the response, but no estimate is available for non-real-time services.
N506
Remark code N506 is an estimate of member liability, not a pre-authorization or payment guarantee. Actual amounts determined upon claim processing.
N507
Remark code N507 indicates that the distance requirements set by the insurance plan have not been fulfilled.
N508
Remark code N508 indicates the patient's financial responsibility for services, as determined by real-time claim adjudication. Members will receive an EOB for details.
N509
Remark code N509 indicates funds are available in the member's Consumer Spending Account to cover liability, but payment depends on fund availability and service eligibility.
N51
Remark code N51 indicates an electronic interchange agreement is missing for the provider/submitter in billing records.
N510
Remark code N510 is an alert indicating insufficient funds in the member's Consumer Spending Account for the claim/service.
N511
Remark code N511 is an alert indicating Consumer Spending Account fund availability for member liability on a claim is currently unknown.
N512
Remark code N512 is an alert for the first remittance of a non-NCPDP claim initially submitted in real-time, with no adjudication changes.
N513
Remark code N513 is an alert for the first remittance of a non-NCPDP claim initially submitted in real-time, now with adjudication changes.
N516
Remark code N516 is an alert that the submitted National Provider Identifier and Employer Identification Number do not match.
N517
Remark code N517 is an instruction to resubmit a new claim with the specified additional information for processing.
N518
Remark code N518 is a notice that accessories provided with oxygen equipment are not paid for separately by insurers.
N519
Remark code N519 is an alert indicating an error due to incompatible HCPCS modifiers used in a claim submission.
N52
Remark code N52 indicates a claim denial because the patient wasn't in the provider's managed care plan on the service date.
N520
Remark code N520 indicates a payment was made using a Consumer Spending Account, affecting claim processing.
N521
Remark code N521 is an alert indicating a discrepancy between the provider details submitted and those on record.
N522
Remark code N522 is an alert that a claim is a duplicate of one already processed or pending as a crossover claim.
N523
Remark code N523 indicates the payer's outlier payment limit for this service period has been reached, thus no outlier payment for this claim.
N524
Remark code N524 indicates that the payment received is considered final as per the policy guidelines.
N525
Remark code N525 indicates services aren't covered if performed during another service's global period.
N526
Remark code N526 is an explanation that the claim isn't eligible for recovery due to the employer's size.
N527
Remark code N527 is an explanation that the claim was processed as primary before a recovery demand was received.
N528
Remark code N528 indicates that the patient's insurance covers only institutional services, not individual treatments.
N529
Remark code N529 is an alert indicating the patient's coverage is limited to professional services only.
N53
Remark code N53 indicates an issue with the claim due to a missing or invalid pick-up address detail.
N530
Remark code N530 is an alert that recovery is not possible due to enrollment details.
N531
Remark code N531 is an explanation that recovery is not possible due to direct premium payments by the insured.
N532
Remark code N532 is an explanation for denial, indicating ineligibility for recovery due to disability/work status.
N533
Remark code N533 is an indicator for services rendered in an Indian Health Services facility under a tribal self-insured Group Health Plan.
N534
Remark code N534 is an alert that the policy is individual, not employer-sponsored.
N535
Remark code N535 is an adjustment notice for payments when a procedure's code and service location affect the reimbursement amount.
N536
Remark code N536 is an explanation that the prior payer's patient responsibility decision remains unchanged, allowing collection for uncovered services.
N537
Remark code N537 is an alert indicating that after reviewing claims history, no records of the provided services were found.
N538
Remark code N538 is an alert that payment for services/supplies/drugs by outside providers is the facility's responsibility.
N539
Remark code N539 is an alert indicating that appeals or waiver requests processed on behalf of the provider have been denied.
N54
Remark code N54 indicates a discrepancy between claim details and pre-certified or authorized services.
N540
Remark code N540 is an adjustment notice for payments affected by the interrupted stay policy in healthcare billing.
N541
Remark code N541 is an alert indicating a discrepancy between the insurance type code submitted and our records.
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