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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
N636
Remark code N636 is an adjustment notice indicating a service is only reimbursable once per injury.
N637
Remark code N637 is an alert that consultations by the same provider post-treatment are not permitted for billing.
N638
Remark code N638 indicates payment was adjusted based on the home health fee schedule.
N639
Remark code N639 indicates payment was aligned with the inpatient rehab facility fee schedule.
N64
Remark code N64 indicates that a claim's 'from' and 'to' dates of service must not be the same for processing.
N640
Remark code N640 indicates a claim exceeds the number or frequency of services approved or allowed within a specific time period.
N641
Remark code N641 is an explanation for reimbursement based on the rated body areas.
N642
Remark code N642 is an adjustment for billing individual tests rather than as a panel, affecting reimbursement.
N643
Remark code N643 indicates services billed are not covered in the state's fee schedule, meaning they're ineligible for payment.
N644
Remark code N644 indicates payment was adjusted following the bilateral procedure rule, affecting reimbursement amounts.
N645
Remark code N645 is an indication that a mark-up allowance has been applied to the healthcare service billing.
N646
Remark code N646 indicates reimbursement adjustment due to assistant guidelines.
N647
Remark code N647 is an adjustment notice indicating billing changes based on the diagnosis-related group (DRG) classification.
N648
Remark code N648 is an adjustment notice indicating billing reached the stop loss limit set by the payer's policy.
N649
Remark code N649 is an indication that payment was determined according to the submitted invoice details.
N65
Remark code N65 indicates a claim issue where the procedure code/rate count is undetermined or not on file for the service date/provider.
N650
Remark code N650 indicates a claim denial because the policy was inactive on the date of the incident. Coverage is unavailable.
N651
Remark code N651 indicates a lack of Personal Injury Protection/Medical Payments Coverage in the policy during the loss event.
N652
Remark code N652 is an alert indicating the service date precedes the loss date, requiring verification or correction.
N653
Remark code N653 is an alert that the injury date and reported loss date do not align, requiring verification.
N654
Remark code N654 is an adjustment notice indicating maximum medical improvement (MMI) has been achieved, affecting payment.
N655
Remark code N655 is an explanation for payment adjustments based on the provider's geographic location.
N656
Remark code N656 indicates an interest payment due to benefits paid beyond the statutory requirement.
N657
Remark code N657 is an alert indicating services must be billed with the correct procedural code for acceptance.
N658
Remark code N658 is an alert that the billed services are not recognized as medical expenses by the payer.
N659
Remark code N659 indicates an item is not subject to sales tax, clarifying billing and payment processing for healthcare providers.
N660
Remark code N660 indicates that the reimbursement amount already includes sales tax.
N661
Remark code N661 indicates that the provided documentation fails to prove the medical necessity of the services billed.
N662
Remark code N662 is an alert indicating payment consideration awaits the submission of a final bill.
N663
Remark code N663 is an adjustment notice indicating a payment change due to a pre-negotiated agreement.
N664
Remark code N664 is an adjustment due to a legal settlement affecting the claim's reimbursement.
N665
Remark code N665 indicates that services from an unlicensed provider are not eligible for reimbursement.
N666
Remark code N666 indicates that only one evaluation and management code at this service level is covered during the care course.
N667
Remark code N667 is an alert indicating a claim's denial due to the absence of a required prescription.
N668
Remark code N668 indicates an incomplete or invalid prescription, signaling a need for additional information or correction.
N669
Remark code N669 is an adjustment notice indicating billing was aligned with the Medicare fee schedule.
N67
Remark code N67 indicates professional services aren't paid separately as they're included in a facility's payment under a demo project.
N670
Remark code N670 indicates the service code is the primary procedure for Medicare's Multiple Procedure Payment Reduction rule.
N671
Remark code N671 is an explanation for adjustments, indicating payment is aligned with the jurisdiction's cost-charge ratio.
N672
Remark code N672 alerts that the specified amount has been applied to the Health Insurance Offset.
N673
Remark code N673 indicates reimbursement is based on outpatient per diem, factor, or fee schedule amount, affecting payment calculations.
N674
Remark code N674 is an alert that coverage is denied unless a specific prior procedure or service has been completed.
N675
Remark code N675 indicates more details are needed from the injured party for claim processing.
N676
Remark code N676 is an alert that a service is ineligible for payment under the Outpatient Facility Fee Schedule.
N677
Remark code N677 is an alert indicating that submitted films/images will not be returned to the healthcare provider.
N678
Remark code N678 is an alert indicating the absence of required post-operative images or visual field results in a claim submission.
N679
Remark code N679 is an alert for healthcare providers about incomplete or invalid post-op images/visual field results.
N68
Remark code N68 indicates a prior payment is reversed due to patient coverage by a demo project; contact the facility for payment.
N680
Remark code N680 indicates an error due to missing, incomplete, or invalid dates of previous dental extractions.
N681
Remark code N681 indicates a claim issue due to missing, incomplete, or invalid full arch series information.
N682
Remark code N682 is an alert for missing or invalid prior periodontal therapy history in patient records.
N683
Remark code N683 indicates a claim issue due to missing, incomplete, or invalid documentation of prior treatment.
N684
Remark code N684 is an alert that payment was denied because a specialty claim was incorrectly submitted as a general claim.
N685
Remark code N685 is an alert for missing or invalid prosthesis, crown, or inlay codes in healthcare billing submissions.
N686
Remark code N686 is an alert indicating a questionnaire required for payment determination is missing, incomplete, or invalid.
N687
Remark code N687 indicates a reversal of charges due to a patient's retroactive disenrollment from their insurance plan.
N688
Remark code N688 is an alert indicating a reversal due to a medical or utilization review decision.
N689
Remark code N689 is an alert indicating a payment reversal due to a retroactive adjustment in rates.
N69
Remark code N69 indicates a PPS code was altered during claims processing, potentially affecting reimbursement.
N690
Remark code N690 alerts healthcare providers that a reversal has occurred as a result of an appeal they submitted.
N691
Remark code N691 is an alert indicating a reversal in billing due to an appeal submitted by the patient.
N692
Remark code N692 alerts that a reversal occurred due to an incorrect rate in the initial claim adjudication process.
N693
Remark code N693 indicates a claim reversal initiated by the provider's cancellation of the claim.
N694
Remark code N694 is an alert indicating a claim reversal due to provider's resubmission or change to the original claim.
N695
Remark code N695 alerts that a reversal occurred due to wrong patient financial responsibility info initially adjudicated.
N696
Remark code N696 alerts healthcare providers of a reversal due to Coordination of Benefits or Third Party Liability retroactive adjustment.
N697
Remark code N697 is an alert indicating a reversal due to adjustments from a payer's retroactive contract incentive program.
N698
Remark code N698 is an alert indicating coverage loss due to unpaid health insurance premiums after the grace period ends.
N699
Remark code N699 is an adjustment notice for payments affected by the Physician Quality Reporting System Incentive Program.
N7
Remark code N7 indicates that the claim has been processed with consideration under Major Medical provisions.
N70
Remark code N70 indicates that services are bundled for billing and payment under a single comprehensive charge.
N700
Remark code N700 is an adjustment notice for payments based on compliance with the Electronic Health Records Incentive Program.
N701
Remark code N701 is an adjustment notice indicating payment changes due to the Value-based Payment Modifier.
N702
Remark code N702 is an alert indicating a decision was made based on review of past or ongoing claims for similar services.
N703
Remark code N703 is an alert that the service billed conflicts with prior or pending claims, impacting payment.
N704
Remark code N704 is a notification that appeals are not allowed, but corrected claim resubmission is possible if needed.
N705
Remark code N705 indicates that a claim was denied due to incomplete or invalid documentation provided.
N706
Remark code N706 indicates that a claim was denied due to missing documentation required for processing.
N707
Remark code N707 indicates an issue with claims due to incomplete or invalid orders from healthcare providers.
N708
Remark code N708 is an alert indicating that required orders are missing from the billing submission.
N709
Remark code N709 indicates that the documentation or notes provided are incomplete or invalid for processing.
N71
Remark code N71 indicates a processed unassigned claim for specific services was treated as assigned, as mandated by law. Providers must comply.
N710
Remark code N710 is an alert indicating that payment or processing is delayed due to missing documentation or notes.
N711
Remark code N711 is an alert indicating the summary provided is incomplete or invalid, requiring attention for claim processing.
N712
Remark code N712 indicates a claim rejection due to the absence of a required summary document in the submission.
N713
Remark code N713 indicates an insurance claim was denied due to an incomplete or invalid report submitted by the healthcare provider.
N714
Remark code N714 is an alert indicating a required report is missing from the claim submission.
N715
Remark code N715 is an alert indicating a claim's denial due to incomplete or invalid chart documentation.
N716
Remark code N716 is an alert indicating a claim's processing delay due to the absence of the patient's medical chart.
N717
Remark code N717 indicates invalid or missing documentation for a required face-to-face examination.
N718
Remark code N718 indicates a claim denial due to missing documentation for a required face-to-face examination.
N719
Remark code N719 indicates a penalty due to failure in meeting specific plan requirements.
N72
Remark code N72 indicates a PPS code revision by medical reviewers due to lack of clinical record support.
N720
Remark code N720 alerts healthcare providers that a patient has overpaid and may need a refund for the excess amount paid over their responsibility.
N721
Remark code N721 indicates that coverage applies only if the service is part of a clinical trial.
N722
Remark code N722 indicates that the patient needs to use Workers' Compensation Set-Aside funds for the medical service or item payment.
N723
Remark code N723 is an alert that the patient must use Liability Set-Aside funds for the medical service or item payment.
N724
Remark code N724 is an alert that payment should come from No-Fault set-aside funds for the specified medical service or item.
N725
Remark code N725 indicates a liability insurer is responsible for ongoing medical services for the specified diagnosis.
N726
Remark code N726 indicates a conditional payment is not permitted in the healthcare billing process.
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