N506Remark Code (RARC)ActiveInformational Alert
N506 Remark Code - Member Liability Estimate Alert
The N506 remark code indicates that the information provided is an estimate of the member's financial responsibility based on the available data at the time of processing. It clarifies that this estimate does not equate to pre-authorization or a guarantee of payment, and the actual coverage and member liability will be determined once the claim is fully processed.
What This Alert Tells You
As an ALERT remark code, N506 is purely informational and does not accompany any specific adjustment or denial reason codes. It serves to inform the provider about the nature of the member's liability estimate without affecting claim outcomes.
Common Scenarios
1A provider submits a claim for a surgical procedure and receives an estimate of the patient's out-of-pocket costs back in the remittance advice.
→ The N506 remark signals that the estimated liability is based on preliminary information and is subject to change once the claim is processed.
2A biller receives an 835 for a diagnostic test that includes an estimate of the patient's copayment amount.
→ The presence of the N506 remark indicates that this copayment estimate is not final and may differ after the claim review is completed.
3A healthcare facility bills a patient for a hospital stay and sees the N506 code in the remittance, indicating an estimate was provided.
→ This remark informs the facility that the estimated liability for the patient is not guaranteed and will be finalized after the claim processing.
What to Do
- Do not take any action based solely on the N506 remark; it is informational only.
- Expect that the actual member liability will be communicated once the claim is processed.
What to Check
- Review the claim details to understand the basis of the liability estimate.
- Check the member's eligibility information for coverage specifics.
- Look at the service codes billed to see how they relate to the estimated liability.