Remark code M131 indicates that the claim has been processed but there is an issue due to the absence of the physician financial relationship form. This form is necessary to establish the financial relationship between the physician and the entity providing the service or referring the service. The healthcare provider must submit this form to avoid delays or denials in payment.
Common causes of code M131 are:
1. Incomplete or missing documentation that details the financial relationship between the physician and the healthcare provider or facility.
2. Failure to submit the required physician financial relationship form along with the claim.
3. Errors or discrepancies in the information provided on the financial relationship form, such as incorrect physician identifiers or dates.
4. The form may not have been updated to reflect recent changes in the physician's financial relationship with the provider or facility.
5. The financial relationship form may have been misplaced or lost during the claims submission process.
6. Lack of proper communication between the billing department and the physician's office, leading to oversight in attaching the necessary form.
7. Technical issues with electronic submission systems that may have prevented the form from being included with the claim package.
Ways to mitigate code M131 include implementing a robust tracking system to ensure that all required physician financial relationship forms are completed and on file before submitting claims. Regularly train staff on the importance of these forms and the specifics of when and how they should be collected. Establish a checklist for claim submission that includes verification of the physician financial relationship form for applicable services. Utilize electronic health record (EHR) systems with built-in alerts to flag when a form is due or missing. Conduct periodic audits to identify and rectify any gaps in form collection and retention processes.
The steps to address code M131 involve verifying if the physician financial relationship form was indeed completed and submitted. If the form is missing, promptly obtain the necessary signatures and information from the physician in question. Ensure that the form accurately reflects the financial relationship and services provided. Once completed, resubmit the form along with the claim to the appropriate payer. If the form was previously submitted, locate the submission confirmation and provide proof of submission to the payer for reconsideration of the claim. It's also important to review internal processes to prevent future occurrences of this error.