Remark code N256 indicates that the claim has been flagged due to a missing, incomplete, or invalid name for the billing provider or supplier. This means that the information submitted for the entity responsible for billing the services is either not provided, is not fully provided, or does not match the records, which is necessary for the processing of the claim. To resolve this issue, the billing provider or supplier must ensure that their name is correctly and completely documented on the claim form before resubmission.
Common causes of code N256 are:
1. The billing provider's or supplier's name is not entered on the claim form.
2. The name provided on the claim does not match the name on file with the payer.
3. The claim form contains typographical errors or misspellings in the provider's or supplier's name.
4. The provider's or supplier's name is incomplete, such as missing a middle initial or suffix when required by the payer.
5. The claim was submitted with outdated or incorrect provider information due to changes in practice name, merger, or acquisition.
6. The provider's or supplier's name field is left blank or contains non-alphanumeric characters that are not recognized by the payer's processing system.
7. The claim lacks the necessary credentials or designation (e.g., MD, DO, RN) that may be required to identify the provider or supplier properly.
8. The billing provider's or supplier's National Provider Identifier (NPI) is not included or does not correspond with the name provided on the claim.
Ways to mitigate code N256 include implementing a thorough pre-claim review process to ensure that all provider or supplier names are accurately captured and entered into the billing system. Regularly updating and verifying provider information in the practice management system can also help prevent this issue. Staff training on the importance of complete and accurate data entry, along with the use of automated verification tools, can reduce the occurrence of this error. Additionally, conducting periodic audits of claims before submission can catch and correct any discrepancies related to provider or supplier names.
The steps to address code N256 involve a thorough review and correction process. First, verify the billing provider or supplier information on the claim to ensure that the name is accurate, complete, and formatted correctly according to the payer's requirements. If any discrepancies are found, update the information and resubmit the claim. If the information appears correct, contact the payer to clarify the specific issue they have identified and obtain guidance on how to rectify it. It may also be beneficial to review your practice management system's default settings to ensure that the correct billing provider or supplier information is being auto-populated on future claims. After making the necessary corrections, resubmit the claim with the updated information as soon as possible to minimize delays in payment.