Remark code N85 indicates that the payment being processed is the final installment of a previously arranged payment plan. This means that after this payment is made, there will be no more scheduled payments for the associated claim or service. Providers should adjust their records accordingly to reflect that the payment plan has been fulfilled with this transaction.
Common causes of code N85 are typically associated with situations where the payment being processed is the last in a series of installment payments agreed upon for a particular claim or service. This could be due to a prior arrangement between the healthcare provider and the payer to settle a claim over a specified period, or it could be the result of a payment plan set up for a patient's account that is nearing completion. Additionally, code N85 may be triggered if there is a discrepancy in the expected payment schedule, prompting the need for clarification or adjustment to ensure that the installment payments align with the agreed terms.
Ways to mitigate code N85 include ensuring that your billing department is aware of the payment plan agreed upon with the payer and that the installment payments are being tracked accurately. Regularly review the account balance and payment history to confirm that all installments are being applied correctly. Communicate with the payer to verify the number of payments remaining and the total balance expected. If there is a discrepancy, address it promptly with the payer to avoid confusion or errors in the final installment. Additionally, maintain clear and detailed records of all communications and transactions related to the installment plan to facilitate resolution of any issues that may arise.
The steps to address code N85 involve confirming that the payment received matches the expected final installment amount as per the patient's payment plan or agreement. Review the patient's account to ensure all previous installments have been posted correctly and reconcile the total payments with the outstanding balance. If there is a discrepancy, investigate the cause and make any necessary adjustments to the account. Once the final payment is confirmed and the account balance is zero, update the patient's billing record to reflect that the payment plan has been fulfilled. Document all actions taken to resolve the code for accurate record-keeping and compliance. If the final installment does not match the expected amount, contact the payer for clarification and to resolve any outstanding issues.