N444Remark Code (RARC)ActiveInformational Alert
N444 Remark Code - Informational Alert on Compliance
The N444 remark code indicates that the facility has not submitted the required Election for High Cost Outlier form to the Division of Workers' Compensation. This alert serves as a notification rather than a denial, meaning no financial adjustment is associated with it, but it highlights a compliance issue that needs attention.
What This Alert Tells You
As an informational alert, the N444 remark code does not accompany any specific adjustment or reason code. It is intended to inform facilities about compliance requirements related to high-cost outlier claims.
Common Scenarios
1A facility receives an 835 remittance for a workers' compensation claim that includes the N444 remark code. The claim was for a surgical procedure that potentially qualifies for high-cost outlier coverage.
→ The presence of the N444 remark code suggests the facility may be missing a critical form that is necessary to ensure proper reimbursement for high-cost services. The payer expects the facility to rectify this compliance issue.
2During routine billing reconciliation, a facility notices that several claims have the N444 remark code attached. These claims involve extensive treatment for work-related injuries.
→ The N444 alert indicates that the facility has not filed the necessary Election for High Cost Outlier form, which could impact future claim approvals and reimbursements for high-cost cases.
3A biller reviews a series of remittance advices and sees the N444 remark code alongside claims for high-cost outlier services provided in a workers' compensation case.
→ The N444 remark serves as a reminder that the facility must address the filing of the Election for High Cost Outlier form to align with compliance requirements and potentially secure reimbursement.
What to Do
- Do not resubmit claims based solely on this alert; it is informational only.
- Ensure that the Election for High Cost Outlier form is completed and submitted to the Division of Workers' Compensation.
What to Check
- Confirm whether the Election for High Cost Outlier form has been filed with the appropriate authority.
- Review the facility's compliance records regarding high-cost outlier requirements.
- Check the claim documentation for any notes related to the high-cost outlier process.