N560Remark Code (RARC)Active
N560 Remark Code - Claim Not Received Within 60 Days
The N560 remark code indicates that the pilot program mandates submission of an interim or final claim within 60 days following the Notice of Admission, but the payer did not receive a claim. This remark serves as a notification that the required claim was not submitted in the specified timeframe.
How It Relates to the Denial
The N560 remark code typically accompanies claim adjustment reason codes related to the absence of required documentation or claims. The combination signals that the payer is referencing the lack of a timely claim submission as per the pilot program's guidelines.
Common Scenarios
1A hospital submitted a claim for inpatient services following a patient's admission, but the claim was not sent within the required 60 days after the Notice of Admission.
→ The N560 remark code suggests that the hospital failed to submit the claim within the mandated timeframe, which could lead to denial or adjustment of payment.
2A facility received an adjustment on a claim for a patient admitted under a pilot program, and the remittance included the N560 remark code.
→ This indicates that the facility did not submit the required interim or final claim within 60 days of the Notice of Admission, resulting in a payment issue.
3A provider is reviewing a remittance for a claim submitted after a patient's admission and finds the N560 remark code listed alongside a denial adjustment reason code.
→ The presence of the N560 remark code clarifies that the reason for the denial is the failure to submit a claim in accordance with the pilot program's 60-day requirement.
What to Do
- Submit the interim or final claim if it has not been sent yet, ensuring it is within the 60-day window from the Notice of Admission.
- If the claim was submitted but within the incorrect timeframe, check if a corrected claim can be filed.
What to Check
- The Notice of Admission date to confirm the 60-day submission window.
- The claim submission records to determine if the claim was filed and when it was sent.
- The payer's policy documentation for any specific requirements related to the pilot program.
- Previous remittance advice to see if similar issues have been noted for other claims.