N135Remark Code (RARC)Active
N135 Remark Code - Patient Responsibility for Record Fees
The N135 remark code indicates that the record fees associated with the claim are the patient's responsibility, but they are limited to a specified co-payment amount. This means that the patient is expected to pay this fee directly, and it should not exceed the amount outlined in the patient's benefits or plan details.
How It Relates to the Denial
The N135 remark code typically accompanies a Claim Adjustment Reason Code that reflects a patient responsibility adjustment. Together, they signal that the billed amount was adjusted because it falls under the patient's financial obligation, specifically regarding co-payments for services rendered.
Common Scenarios
1A patient received a service that included record fees, and the claim was submitted for payment. The remittance came back with a reason code indicating a reduction for patient responsibility.
→ The N135 remark code clarifies that the patient is responsible for the record fees, but only up to the co-payment amount specified in their insurance plan.
2A claim for a diagnostic test was submitted, and the remittance statement indicated a deduction for record fees. The adjustment reason code related to patient cost-sharing was noted.
→ With the N135 remark, it is clear that the payer expects the patient to cover the record fees, which should not exceed the predetermined co-payment amount.
3After billing for a procedure that included additional record fees, the remittance report showed an adjustment for patient responsibility along with the N135 remark code.
→ This indicates to the biller that the payer expects the patient to pay these record fees, limited to the specified co-payment, as per their insurance agreement.
What to Do
- Verify the patient's benefit plan to confirm the specified co-payment amount for record fees.
- Inform the patient of their responsibility for the record fees as indicated by the N135 remark.
- Ensure that future claims reflect the correct co-payment amounts to avoid similar adjustments.
What to Check
- The patient's benefits summary to identify the co-payment amount for record fees.
- The remittance advice for the accompanying claim adjustment reason code for context.
- The claim details to ensure that record fees were billed correctly and align with the patient's financial responsibility.