N407Remark Code (RARC)Active
N407 Remark Code - Not Approved Submitter for Format
The N407 remark code indicates that the provider is not recognized as an approved submitter for the transmission format used in the claim submission. This remark serves to clarify the adjustment made by the accompanying reason code, which likely pertains to the denial of the claim due to submission format issues.
How It Relates to the Denial
N407 typically accompanies denial reason codes related to claim submission format problems. This combination signals that the claim was not processed because the provider does not have authorization to submit claims in the current format.
Common Scenarios
1A provider submitted a claim for a specialty service using a specific electronic format, but the remittance received shows denial due to submission format issues.
→ The N407 remark code indicates that the provider's submission was rejected because they are not an approved submitter for that format, prompting a review of submission protocols.
2A facility billed outpatient services through an EDI transaction, only to receive a remittance stating the claim was denied, with N407 included in the details.
→ The appearance of N407 suggests the claim was not processed due to the facility's lack of approval for the transmission format, necessitating verification of submission rights.
3A provider sent a claim electronically but received a remittance that included N407, indicating a problem with the submission format.
→ This remark points to the fact that the provider's electronic claim was rejected because they are not authorized to submit in that particular format, thus requiring further investigation.
What to Do
- Review the submission format used for the claim to ensure it aligns with approved formats.
- Contact the payer to confirm the approved submitter status for the transmission format used.
- Consider resubmitting the claim in an authorized format if applicable.
What to Check
- Verify the provider's approval status with the payer for the specific transmission format.
- Check the claim submission documentation to ensure compliance with payer requirements.
- Examine the accompanying reason code for additional context regarding the denial.