Remark code N186 indicates that a Non-Availability Statement (NAS) is required for the service billed. The provider should contact the nearest Military Treatment Facility (MTF) for assistance in obtaining this statement.
Common causes of code N186 are the failure to provide a Non-Availability Statement (NAS) when billing for services that require confirmation that the service is not available at a Military Treatment Facility (MTF), or the NAS provided is incomplete, invalid, or not properly documented in the patient's records. Additionally, this code may be used if there is a lack of coordination with the MTF or if the provider did not follow the proper protocol in obtaining the NAS prior to rendering services to a beneficiary of a military health plan.
Ways to mitigate code N186 include establishing a protocol to check for the necessity of a Non-Availability Statement (NAS) prior to rendering services typically provided by a Military Treatment Facility (MTF). Ensure that your scheduling and registration staff are trained to identify services that may require an NAS and have a clear process in place for obtaining the necessary documentation. Additionally, consider implementing a system that flags services for which an NAS might be needed, prompting staff to verify whether the patient has sought care from an MTF first or to assist them in obtaining the required NAS. Regularly review and update your procedures to stay compliant with any changes in requirements for military beneficiaries.
The steps to address code N186 involve several actions to ensure proper handling and resolution. Firstly, verify the necessity of the Non-Availability Statement (NAS) for the service provided. If the NAS is indeed required, contact the nearest Military Treatment Facility (MTF) to obtain the necessary documentation. Ensure that the NAS is complete and accurate, reflecting the service date and details that match the claim.
Once you have the NAS, attach it to the claim and resubmit it to the payer. If the NAS had been previously obtained but was not submitted with the original claim, attach it to the claim with an explanation and resubmit.
In the case where the NAS is not applicable or you believe the code was applied in error, gather all supporting documentation that justifies why the service does not require an NAS. Prepare a clear and concise appeal letter, including all relevant information and evidence, and submit it to the payer according to their appeals process.
Throughout this process, document all communications and steps taken to resolve the issue. This documentation will be crucial if further follow-up is necessary or if the payer requires additional information. It's also important to review internal processes to ensure that future claims for similar services include the NAS when required, to prevent the recurrence of this issue.