Remark code N279 indicates that the claim submitted has been flagged due to a missing, incomplete, or invalid name for the pay-to provider. This means that the information necessary to identify the healthcare provider or organization that should receive payment for the services rendered is either not present, not fully provided, or contains errors that prevent proper processing of the payment. To resolve this issue, the healthcare provider must review the claim, correct the pay-to provider information, and resubmit the claim for reimbursement.
Common causes of code N279 are incorrect or missing information on the claim form regarding the provider's name to whom the payment should be made, data entry errors that lead to incomplete provider names, or the submission of claims with a provider name that does not match the name on file with the payer. Additionally, this code may be triggered if there is a discrepancy between the provider's legal name and the doing business as (DBA) name, or if the provider's name has changed due to a merger or acquisition but the payer's records have not been updated.
Ways to mitigate code N279 include implementing a robust verification process for all provider information before claim submission. This can involve double-checking the provider's name against the National Provider Identifier (NPI) database and ensuring that the name on the claim matches exactly with the name associated with the NPI. Additionally, training staff to recognize and correct discrepancies in provider information and utilizing software that automatically flags missing or inconsistent data can help prevent this code. Regular audits of provider information in your billing system can also catch errors before claims are submitted.
The steps to address code N279 involve verifying and updating the pay-to provider information in your billing system. First, review the claim to ensure that the provider's name is spelled correctly and matches the name on file with the payer. If the name is incorrect, correct it and resubmit the claim. If the name is accurate, check that all required provider identifiers, such as the National Provider Identifier (NPI) and tax identification number (TIN), are present and correct. Additionally, ensure that the provider's address and contact information are complete and up-to-date. If any information is missing or incomplete, update the records and resubmit the claim. If all information appears correct, contact the payer to clarify the specific issue they have identified and to confirm that your records match their files. Once any discrepancies are resolved, resubmit the claim for processing.