Remark code N295 indicates that the claim has been flagged because the secondary identifier for the service facility is either missing, incomplete, or invalid. This means that the information provided to identify the facility where services were rendered does not meet the payer's requirements, and the claim may need to be corrected and resubmitted with the appropriate identifier information.
Common causes of code N295 are:
1. The claim was submitted without the necessary secondary identifier for the service facility, such as a non-standard facility ID or taxonomy code.
2. The secondary identifier provided on the claim is incomplete, possibly due to a missing digit or character.
3. An incorrect secondary identifier was entered for the service facility, which does not match the records with the payer.
4. The format of the secondary identifier is invalid, perhaps due to improper coding or a mismatch with the standard formats required by the payer.
5. The claim form may have been filled out incorrectly, with the secondary identifier placed in the wrong field or section.
6. The electronic claim file may have been corrupted or not properly formatted, leading to the omission or misrepresentation of the secondary identifier.
7. There may have been a clerical or data entry error when inputting the secondary identifier information into the billing system or onto the claim form.
8. The payer's database might not have the updated or correct information regarding the service facility's secondary identifier, leading to a mismatch when the claim is processed.
Ways to mitigate code N295 include ensuring that all claims submitted have the correct and complete secondary identifier for the service facility. This can be achieved by implementing a robust verification process within your billing software that checks for the presence and accuracy of secondary identifiers before claims are submitted. Regularly updating your facility information in the payer's database and training staff on the importance of including complete facility details can also help prevent this code. Additionally, conducting periodic audits of claims to identify and rectify any recurring issues with secondary identifiers can be beneficial.
The steps to address code N295 involve verifying the service facility information on the claim. Begin by reviewing the claim form to ensure that the secondary identifier, such as a National Provider Identifier (NPI) for the service facility, is present and accurately entered. If the identifier is missing or incorrect, obtain the correct information from the facility's administrative records or by contacting the facility directly. Update the claim with the valid secondary identifier and resubmit the claim to the payer. Additionally, implement a process to routinely check for accurate secondary identifiers on future claims to prevent recurrence of this issue.