MA64Remark Code (RARC)Active
MA64 Remark Code - Third Payer Processing Delay
The MA64 remark code indicates that the payer has identified itself as the third payer for the claim in question. The claim cannot be processed until payment information from the primary and secondary payers has been received and documented.
How It Relates to the Denial
This supplemental remark code typically accompanies a claim adjustment reason code that indicates a denial or hold due to lack of payment information from prior payers. The combination signals that the payer is awaiting necessary payment details before proceeding with the claim.
Common Scenarios
1A provider submits a claim for a procedure after billing the primary and secondary insurers. The remittance advice returns with a denial indicating that payment cannot be processed.
→ The MA64 remark code suggests that the payer recognizes its role as the third payer, but it cannot finalize processing until the primary and secondary payment statuses are confirmed.
2A patient receives treatment that involves multiple insurance plans. The third payer remittance shows a denial with the MA64 code listed.
→ In this case, the MA64 remark is highlighting that the third payer requires confirmation of payments from both the primary and secondary payers before it can process the claim.
3A claim for a service is sent to a payer that serves as the third in line after two others. The payer returns the claim with a remark indicating it cannot proceed.
→ The presence of the MA64 remark code indicates that the third payer is unable to act on the claim until it receives necessary payment information from the first two payers.
What to Do
- Do not resubmit the claim until you have obtained payment information from the primary and secondary payers.
- Once the information is received, submit the updated claim with the relevant payment details included.
What to Check
- Review the remittance advice from the primary and secondary payers for payment details.
- Check the claim submission history to ensure that primary and secondary claims were correctly billed and processed.
- Verify the patient's insurance coverage to confirm the order of payers.