Remark code N144 indicates that the payment rate for a particular service was altered during the period in which the services were provided. This could mean that the reimbursement amount expected by the healthcare provider may differ from the amount initially quoted or billed due to a change in the fee schedule or contracted rate within the billing period. Providers should review the dates of service in question and adjust their billing records or claims accordingly to reflect the updated rate.
Common causes of code N144 are:
1. The submission of claims for a period that spans across a rate update or change, resulting in different reimbursement rates applicable to the services provided.
2. Incorrectly applying an old rate to services rendered after a new rate has been implemented by the payer.
3. Failure to update the billing system or charge master to reflect the new rates in a timely manner, leading to discrepancies between billed and allowed amounts.
4. A lag in communication from the payer regarding rate changes, causing the provider to bill with outdated information.
5. Manual entry errors where the incorrect rate is applied to the dates of service due to oversight or misunderstanding of the effective date of the new rate.
6. Systematic errors where the automated claims processing system does not properly account for the rate change effective date.
7. Contractual amendments or renegotiations that have not been fully integrated into the billing process at the time of claim submission.
Ways to mitigate code N144 include implementing a robust charge capture system that flags changes in payer rates and updates billing systems in real time. Regularly training billing staff on the latest payer rate schedules and ensuring they have access to updated contract information can also help. Additionally, setting up automated alerts for when contracts are due for renegotiation or when payer rates are set to change can prevent billing at outdated rates. It's also beneficial to conduct periodic audits of billed services to ensure that the rates charged match the current contracted rates with payers.
The steps to address code N144 involve a thorough review of the claim and the contract terms with the payer. First, verify the dates of service and the rate in effect for those dates according to the payer's fee schedule. If the rate change is valid, adjust the billing amount accordingly and resubmit the claim. If the rate change is not accurate or not properly communicated by the payer, gather documentation supporting the correct rate and contact the payer to dispute the adjustment. Ensure that all communication with the payer is documented, and follow up regularly until the issue is resolved. If necessary, reprocess the claim with the correct rate and dates of service to expedite reimbursement.