MA91Remark Code (RARC)ActiveInformational Alert
MA91 Remark Code - Appeal Determination Alert
The MA91 remark code indicates that the determination reflected in the remittance advice is a result of an appeal that was filed. This alert serves to inform the provider that the outcome of the appeal process has been communicated, but it does not involve any payment adjustments or denials.
What This Alert Tells You
As an informational alert, MA91 is not associated with any specific adjustment or denial reason codes. It simply notifies the provider of the appeal's outcome without any financial implications tied to the code itself.
Common Scenarios
1A provider receives an 835 remittance advice showing an adjustment related to a previously denied claim that was appealed.
→ The MA91 alert indicates that the outcome of the appeal is now reflected in the remittance, confirming the result of that process.
2After filing an appeal for a service that was initially denied, the provider sees the MA91 remark on their remittance advice.
→ The presence of MA91 confirms that the payer has made a determination regarding the appeal, providing clarity on the appeal's status.
3A billing office reviews an 835 report and notices the MA91 alert next to a claim for which an appeal was submitted.
→ This remark indicates that the determination is directly linked to the appeal, helping the billing office understand the context of the payment or adjustment.
What to Do
- Do not take any action in response to this alert as it is informational only.
- Review the appeal outcome as indicated in the remittance advice for further context.
What to Check
- The appeal documentation to confirm the details of the appeal submission.
- The remittance advice to understand how the appeal outcome affects the claim.
- Any communication from the payer regarding the appeal decision.