DENIAL CODES

Denial code N32

Remark code N32 indicates that a claim should be filed by the healthcare provider who actually performed the service.

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What is Denial Code N32

Remark code N32 indicates that the claim in question must be submitted by the healthcare provider who actually performed or delivered the service to the patient. This means that if a different entity or provider attempts to submit the claim for reimbursement, it will not be processed until the correct provider—the one who provided the care—submits the claim. This is to ensure that payment is made directly to the provider responsible for the service.

Common Causes of RARC N32

Common causes of code N32 are:

1. The claim was submitted by an entity other than the provider who actually performed the service, such as a billing service or a different healthcare provider.

2. There is a mismatch between the National Provider Identifier (NPI) on the claim and the NPI of the provider who delivered the service.

3. The claim form may have been filled out incorrectly, with the wrong provider information entered in the billing provider section.

4. In the case of group practices, the claim might not have been attributed to the specific provider who rendered the service but to the group instead.

5. The provider who rendered the service may not be properly credentialed or enrolled with the payer, leading to a rejection of the claim when submitted by the correct provider.

6. There could be an error in the payer's system, incorrectly flagging the claim as submitted by an incorrect provider despite accurate submission.

7. The claim may have been re-assigned incorrectly due to a clerical error or misunderstanding of billing protocols, especially in complex cases involving multiple providers or referrals.

Ways to Mitigate Denial Code N32

Ways to mitigate code N32 include ensuring that claims are always submitted under the National Provider Identifier (NPI) of the healthcare professional who actually performed the service. It's important to have a robust verification process in place to confirm that the provider information on the claim matches the service documentation. Additionally, staff training on proper billing practices and regular audits of claim submissions can help prevent this issue. Implementing a system that automatically flags claims with mismatched provider details can also be an effective strategy in preventing remark code N32.

How to Address Denial Code N32

The steps to address code N32 involve verifying the accuracy of the claim submission. First, confirm that the National Provider Identifier (NPI) and other provider information on the claim match the actual provider who performed the services. If there is a discrepancy, correct the provider details and resubmit the claim. If the information is accurate, but the claim was still rejected, contact the payer to determine if there was a processing error. In cases where services were rendered by a provider under a group or facility, ensure that the billing arrangements are in accordance with the payer's requirements and that the claim reflects this relationship appropriately. If necessary, update the billing practices to prevent future occurrences of this code.

CARCs Associated to RARC N32

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