N385Remark Code (RARC)Active
N385 Remark Code - Admission Notification Timeliness
The N385 remark code indicates that the notification of admission was not timely according to the published procedures of the payer's plan. This remark supplements an adjustment that has already been detailed by a Claim Adjustment Reason Code on the same remittance, offering additional context for the denial or reduction in payment.
How It Relates to the Denial
The N385 remark typically accompanies adjustment reason codes that relate to late notifications or authorizations for admissions. This combination signals that the payer is enforcing their timeliness requirements as outlined in their guidelines.
Common Scenarios
1A facility billed for an inpatient admission but received a denial stating that the admission was not authorized due to late notification.
→ In this case, the N385 remark clarifies that the late notification of the patient's admission is the reason for the denial, emphasizing the importance of adhering to the payer's notification timelines.
2A provider submitted a claim for a patient who was admitted to the hospital, but the remittance shows a reduction in payment with a reason code related to authorization.
→ Here, the N385 remark explains that the reduction is due to the failure to notify the payer of the admission within the required timeframe, indicating that timely notification is a critical requirement.
3An outpatient service was billed following an inpatient stay, but the remittance indicated a denial based on a lack of timely admission notification.
→ The N385 remark in this instance highlights that the issue lies in the admission notification process, which should have been completed according to the payer's established procedures.
What to Do
- Review the notification process for admissions to ensure compliance with the payer's guidelines.
- Consider resubmitting the claim if the admission notification was timely based on your records, but ensure you include the necessary documentation to support this.
- Communicate with the patient or facility to gather any evidence of timely notification that may not have been submitted initially.
What to Check
- The payer's published procedures regarding admission notifications and their timelines.
- The claim adjustment reason code accompanying the N385 remark for additional context.
- Records of the admission notification submitted to the payer, including dates and methods of communication.