Remark code N274 indicates that the claim submitted is lacking or contains an incomplete or invalid identifier for another provider that is associated with the other payer involved. This means that additional information is required regarding the other healthcare provider's identification to process the claim with the secondary or tertiary payer.
Common causes of code N274 are:
1. The secondary or tertiary insurance information provided does not include the necessary provider identifier, such as a National Provider Identifier (NPI).
2. The claim form is missing the required provider identifier for the other payer, leading to incomplete information.
3. Incorrect or invalid provider identifiers have been entered for the other payer, which do not match the records or are not recognized by the payer's system.
4. The claim was submitted without updating or verifying the other payer's provider information, which may have changed since the last submission.
5. The electronic claim submission process may have encountered a formatting error, causing the provider identifier for the other payer to be omitted or corrupted.
6. Manual entry errors where the provider identifier is either mistyped or left out entirely when processing the claim for the other payer.
Ways to mitigate code N274 include implementing a robust verification process to ensure that all claims include the correct and complete identifiers for other payers and providers involved. This can be achieved by:
1. Training staff on the importance of collecting and verifying other payer and provider information before claim submission.
2. Utilizing electronic health record (EHR) systems that prompt for required fields and identifiers, reducing the likelihood of omissions.
3. Establishing a double-check system where claims are reviewed by a second set of eyes for accuracy and completeness of all identifiers.
4. Keeping up-to-date with payer requirements and ensuring that the billing team is aware of any changes in identifier formats or policies.
5. Integrating automated verification tools that cross-reference provider identifiers against a database to confirm their validity before claims are submitted.
6. Regularly auditing claims to identify common errors or patterns that lead to N274 codes and addressing these systematically through process improvements.
7. Encouraging open communication between billing staff and providers to quickly resolve any questions or discrepancies regarding other payer or provider identifiers.
The steps to address code N274 involve a thorough review of the claim to identify the missing or incorrect information related to the other payer's provider identifier. Begin by cross-referencing the claim with the patient's insurance information to ensure that the correct other payer details were used. If the identifier is missing, obtain the correct information from the patient's insurance card or through contact with the other payer. If the identifier is incomplete or invalid, verify the accuracy of the information provided and make the necessary corrections. Once the correct identifier is obtained, update the claim and resubmit it to the payer for processing. It's also advisable to update your billing system or records to prevent future occurrences of this error.