DENIAL CODES

Denial code N664

Remark code N664 is an adjustment due to a legal settlement affecting the claim's reimbursement.

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What is Denial Code N664

Remark code N664 is an indication that the payment adjustment has been made due to a legal settlement.

Common Causes of RARC N664

Common causes of code N664 (Adjusted based on a legal settlement) are disputes over billing practices, disagreements on the contractual payment obligations, or settlements resulting from litigation related to healthcare services provided. This code may also be used when there has been a resolution between the healthcare provider and payer following a legal dispute over the interpretation of a contract's terms, leading to an adjustment in the billed amount.

Ways to Mitigate Denial Code N664

Ways to mitigate code N664 include implementing a robust compliance program that ensures all billing practices align with current laws and regulations. Regularly training staff on legal requirements and conducting periodic audits of billing processes can help identify and correct any practices that might lead to legal disputes. Establishing clear communication channels with payers and seeking clarification on ambiguous billing guidelines can also prevent misunderstandings that could result in legal settlements. Additionally, maintaining comprehensive documentation of all billing activities and payer communications can provide essential evidence in disputes, potentially avoiding the need for legal settlements.

How to Address Denial Code N664

The steps to address code N664, which indicates an adjustment based on a legal settlement, involve a multi-faceted approach focusing on documentation, communication, and financial analysis. Initially, it's crucial to gather all relevant documentation related to the legal settlement that led to this adjustment. This includes the settlement agreement, any court orders, and correspondence with legal counsel that outlines the terms and financial implications of the settlement.

Next, engage with the legal team or legal advisor to fully understand the scope of the settlement and its impact on the billing process. This step ensures that all adjustments are made in compliance with the legal terms agreed upon.

Following this, update the patient's account with detailed notes explaining the adjustment, including references to the legal settlement. This documentation is vital for internal tracking and might be necessary for future audits or inquiries.

Subsequently, review the financial implications of the adjustment on the patient's account. If the settlement results in a balance owed by the patient, consider the patient's financial situation and explore options such as payment plans or financial assistance programs to support the patient in fulfilling their financial responsibility.

Finally, if the adjustment impacts the revenue expectations for the healthcare provider, it's important to communicate these changes to the finance department. They may need to adjust forecasts or financial reporting to accurately reflect the impact of the legal settlement on the organization's financial health.

Throughout this process, maintain open lines of communication with all parties involved, including the patient, legal advisors, and internal departments affected by the adjustment. This ensures a transparent and compliant approach to addressing code N664.

CARCs Associated to RARC N664

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