N376Remark Code (RARC)Active
N376 Remark Code - Military Duty Impacts Coverage
The N376 remark code indicates that the subscriber or patient is currently assigned to active military duty, which may affect their primary insurance coverage. Specifically, this suggests that TRICARE could be the primary payer for this patient, rather than the payer that processed the claim in question.
How It Relates to the Denial
The N376 remark code typically accompanies adjustments related to claims where the patient’s military status impacts coverage. It serves to clarify the reason for a denial or reduction in payment based on the patient's assignment to active military duty, often in conjunction with a claim adjustment reason code that addresses coverage issues.
Common Scenarios
1A claim was submitted for a medical service provided to a patient who is on active military duty. The remittance advice shows a denial with a claim adjustment reason code indicating coverage issues.
→ The presence of the N376 remark code suggests that the denial is due to the patient's military status, indicating that TRICARE may be the primary coverage, and the payer who processed the claim is not responsible for payment.
2A patient received outpatient care, and the claim was processed with an adjustment indicating insufficient coverage. The remittance advice includes N376 as a supplemental remark.
→ This remark indicates that the payer has identified the patient as being on active military duty, which may necessitate filing with TRICARE instead of the current payer.
3A billing office receives a remittance for a claim submitted for a patient who is a dependent of an active military member. The remittance includes N376 along with an adjustment reason code for payment denial.
→ The N376 remark is indicating that the patient's military status affects their coverage, suggesting that TRICARE should be considered as the primary payer.
What to Do
- Verify the patient's military status and ensure that claims are submitted to the appropriate primary payer, which may be TRICARE.
- If applicable, resubmit the claim to TRICARE as the primary payer, including all necessary documentation for coverage.
What to Check
- The patient's eligibility information to confirm active military duty status.
- The plan benefit document to identify primary coverage policies related to military members.
- The claim adjustment reason code that accompanies the N376 remark for additional context on the payment adjustment.