DENIAL CODES

Denial code N698

Remark code N698 is an alert indicating coverage loss due to unpaid health insurance premiums after the grace period ends.

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What is Denial Code N698

Remark code N698 indicates: Alert: This reversal is due to non-payment of the health insurance premiums (Health Insurance Exchange or other) by the end of the premium payment grace period, resulting in loss of coverage.

Common Causes of RARC N698

Common causes of code N698 are missed or late payments of health insurance premiums, insufficient funds to cover the premium amount, administrative errors in processing premium payments, or misunderstandings regarding the grace period's length and conditions. This often leads to a lapse in coverage due to the policy being cancelled or not renewed by the insurance provider.

Ways to Mitigate Denial Code N698

Ways to mitigate code N698 include implementing a robust patient communication strategy that emphasizes the importance of timely premium payments. This could involve sending regular reminders via email, SMS, or postal mail before the due date. Additionally, offering financial counseling services to patients to help them understand their payment options and the consequences of non-payment might prevent lapses in coverage. Establishing a system to track premium payment statuses and alert patients at the first sign of a potential lapse can also be effective. Lastly, partnering with insurance companies to facilitate direct communication about payment issues could help in preventing coverage loss due to unpaid premiums.

How to Address Denial Code N698

The steps to address code N698 involve a multi-faceted approach focusing on both immediate resolution and long-term patient communication strategies. Initially, the billing team should verify the patient's coverage status directly with the insurance provider to confirm the loss of coverage due to non-payment. If the coverage has indeed lapsed, the next step involves reaching out to the patient to inform them of the situation, emphasizing the importance of maintaining their insurance premiums for continuous coverage.

Simultaneously, explore alternative billing options with the patient, such as setting up a payment plan for the outstanding balance, or checking if they qualify for any financial assistance programs your facility may offer. It's also beneficial to educate the patient on how to reinstate their insurance or assist them in finding new coverage if reinstatement is not possible.

To prevent future occurrences, consider implementing a policy where patients are reminded of their premium payment due dates, especially for those enrolled in Health Insurance Exchange plans or other similar programs. This could be through automated reminders via email, SMS, or phone calls. Additionally, training front desk and billing staff to routinely verify insurance coverage prior to appointments can help identify potential issues before services are rendered, thereby minimizing financial risk for both the patient and the provider.

CARCs Associated to RARC N698

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