Remark code N126 indicates coverage denial for services to individuals deported, as per Social Security Records and payer policy.
Remark code N126 indicates that according to Social Security Records, the individual in question has been deported. Consequently, this payer does not provide coverage for items and services rendered to individuals who have been deported.
Common causes of code N126 are:
1. The patient's Social Security records have been flagged due to a deportation action, which has been reported to the relevant government agencies.
2. There may have been an administrative error or mismatch in Social Security data that incorrectly identifies the patient as deported.
3. The healthcare provider may have submitted a claim for a patient without verifying their current immigration or residency status, leading to a denial based on the payer's coverage policies.
4. The payer's internal checks and cross-referencing with government databases have resulted in the application of this code due to the patient's updated status in the Social Security system.
5. There could be a delay in the update of the patient's records if their deportation status has changed, yet the Social Security records have not been corrected or updated at the time of the claim submission.
Ways to mitigate code N126 include ensuring accurate and up-to-date patient demographic information is collected and verified during the registration process. Implement a robust verification system that cross-references patient social security numbers with relevant databases to confirm citizenship or residency status before services are rendered. Additionally, staff should be trained to recognize and address discrepancies in patient information promptly and to understand the importance of maintaining current records to avoid issues with coverage eligibility. Regular audits of patient files for compliance with documentation standards can also help in preventing this code from occurring.
The steps to address code N126 involve verifying the patient's current immigration and residency status. If the patient has indeed been deported, it is important to inform them that the current payer does not cover their medical services and discuss alternative payment options or resources. If the patient's status has been reported incorrectly, obtain the correct documentation proving their legal residency status and submit an appeal to the payer with the updated information. Additionally, review your patient intake and verification processes to ensure accurate information is collected and reported to prevent future occurrences of this issue.
Improve your financial performance while providing a more transparent patient experience
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
