Remark code N248 indicates that the claim has been flagged because the name of the assistant surgeon is either missing, incomplete, or invalid. This means that the information provided for the assistant surgeon on the claim does not meet the payer's requirements, and the claim may be delayed or denied until this information is corrected and resubmitted.
Common causes of code N248 are:
1. The assistant surgeon's name was not provided on the claim submission.
2. The assistant surgeon's name was entered incorrectly, with typos or misspellings.
3. The assistant surgeon's information was incomplete, lacking necessary credentials or identifiers.
4. The claim form used an outdated or incorrect format for the assistant surgeon's name.
5. The assistant surgeon's name does not match the name on file with the payer or the National Provider Identifier (NPI) database.
6. The assistant surgeon's NPI or other required identification numbers were omitted from the claim.
7. The electronic claim submission had a technical error or data mismatch related to the assistant surgeon's information.
Ways to mitigate code N248 include implementing a robust verification process within your billing system to ensure that the assistant surgeon's name is accurately and completely captured at the time of data entry. This can be achieved by:
1. Training staff on the importance of collecting and entering all required surgical team member information, including the assistant surgeon's name, before submitting claims.
2. Utilizing electronic health records (EHR) with built-in prompts or alerts that flag missing or incomplete assistant surgeon information before the claim is finalized.
3. Establishing a checklist for surgical procedures that includes verification of the assistant surgeon's name and credentials as a part of the pre-claim submission review process.
4. Integrating real-time eligibility verification tools that cross-check the assistant surgeon's information with the payer's database to confirm that it is correct and up-to-date.
5. Conducting regular audits of claims to identify patterns of missing or incorrect information and providing feedback and additional training to staff as needed.
6. Collaborating with surgical scheduling departments to ensure that all surgical team members are documented at the time of scheduling and that this information is accurately transferred to the billing department.
By focusing on these strategies, healthcare providers can reduce the occurrence of code N248 and improve the accuracy of their claims submissions.
The steps to address code N248 involve verifying and updating the claim with the correct assistant surgeon's name. First, review the surgical documentation to confirm the assistant surgeon's identity. Ensure that the assistant surgeon's name is spelled correctly and matches the name on file with the payer. If the name is missing, add it to the claim form in the appropriate field. If the name is incomplete or invalid, correct the information accordingly. Once the necessary corrections are made, resubmit the claim to the payer for processing. It's also advisable to check that the assistant surgeon's credentials and provider numbers are accurate and up-to-date to prevent further issues with the claim.