Denial code N516

Remark code N516 is an alert that the submitted National Provider Identifier and Employer Identification Number do not match.

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What is Denial Code N516

Remark code N516 indicates that there is a discrepancy between the National Provider Identifier (NPI) and the Employer Identification Number (EIN) that were submitted.

Common Causes of RARC N516

Common causes of code N516 are incorrect entry of the National Provider Identifier (NPI) or Employer Identification Number (EIN) on the claim form, a change in provider information that has not been updated with the payer, or a discrepancy between the NPI and EIN information on file with the payer and the information submitted on the claim. This can also occur if the billing provider's NPI does not match the NPI registered for the corresponding EIN with the payer, or if there has been a recent change in ownership or tax identification information that has not been communicated to the payer.

Ways to Mitigate Denial Code N516

Ways to mitigate code N516 include ensuring that the National Provider Identifier (NPI) and Employer Identification Number (EIN) are accurately recorded and match across all platforms and documents before submission. Regularly updating and verifying these details in the provider's billing system and with payers can prevent discrepancies. Implementing a double-check system where another team member reviews these critical identifiers for accuracy can also reduce the risk of mismatches. Additionally, training staff on the importance of precise data entry and the impact of such errors on the revenue cycle can help minimize occurrences of code N516.

How to Address Denial Code N516

The steps to address code N516 involve a multi-faceted approach to ensure the correct alignment of the National Provider Identifier (NPI) and Employer Identification Number (EIN). Initially, conduct a thorough review of the submitted claim to verify the accuracy of both the NPI and EIN as entered. If discrepancies are found, correct the information directly on the claim form. In parallel, engage with your billing software or system to update the provider's profile, ensuring that all future claims automatically include the correct NPI and EIN details. Additionally, it's prudent to reach out to the payer to confirm their records have been updated to reflect the correct information, preventing future occurrences of this code. If the issue persists despite these corrections, consider a direct liaison with the payer to understand any underlying mismatch in their system that might be causing the code to trigger. This proactive communication can often illuminate specific payer requirements or additional verification steps that may not be immediately apparent.

CARCs Associated to RARC N516

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