Remark code N732 indicates that services at unlicensed facilities are not covered for reimbursement.
Remark code N732 is an indication that the services provided were performed at a facility that does not hold the necessary licensing, and as a result, reimbursement for these services will not be provided.
Common causes of code N732 are services being rendered at a facility that does not have the appropriate licensing or accreditation required by the payer, the facility's license has expired, or the services were provided at a location that is not recognized as a licensed facility by the insurance company. Additionally, this code may be used if there is a discrepancy in the facility's information, leading the payer to believe it is unlicensed.
Ways to mitigate code N732 include ensuring that all services are provided in facilities that have current and valid licensing. Regularly verify the licensing status of all facilities where services are rendered, and maintain an updated database of these verifications. Implement a pre-service check process to confirm that the facility's license is active and covers the date of service. Additionally, educate providers and administrative staff about the importance of facility licensing in the reimbursement process and develop a protocol for quickly addressing any lapses in facility licensing to prevent future occurrences of this code.
The steps to address code N732 involve several key actions to ensure compliance and facilitate reimbursement. First, verify the accuracy of the facility's licensure status at the time of service. If the facility was indeed licensed, gather all necessary documentation proving licensure and submit an appeal to the payer with this evidence. If the service was inaccurately billed under an unlicensed facility, correct the billing information to reflect the licensed facility where the service was actually performed, if applicable, and resubmit the claim. In cases where services were rendered at an unlicensed facility due to an oversight or misunderstanding, explore the possibility of transferring the patient's care records to a licensed facility for future services to prevent recurrence of this issue. Additionally, implement a verification process for facility licensure status as part of the pre-service or pre-authorization procedures to avoid similar denials in the future.
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