N619Remark Code (RARC)Active
N619 Remark Code: Coverage Terminated for Non-Payment
The N619 remark code indicates that the patient's coverage has been terminated due to non-payment of premium. This means that the payer is informing the provider that the patient’s insurance policy is no longer active, impacting the claim's payment status.
How It Relates to the Denial
The N619 remark typically accompanies adjustment reason codes that indicate a claim denial due to lack of coverage. The combination signifies that the claim cannot be processed because the patient is not currently insured with the payer.
Common Scenarios
1A provider submits a claim for a routine office visit, but the remittance advises that payment is denied due to lack of coverage.
→ The N619 remark suggests that the patient’s insurance has been terminated because premiums were not paid, confirming that the visit is not covered.
2A claim for a surgical procedure is submitted, and the remittance response includes a claim adjustment reason code indicating denial for non-coverage.
→ With the N619 remark present, it clarifies that the denial is due to the patient's coverage being inactive as a result of non-payment.
3A patient receives physical therapy services, and the billing office receives a remittance showing an adjustment for no payment due to terminated coverage.
→ The N619 remark points to the fact that the patient’s insurance is no longer valid, preventing any reimbursement for the services rendered.
What to Do
- Verify the patient's insurance status and payment history to confirm coverage termination.
- Communicate with the patient regarding their premium payment status and the implications for coverage.
- Consider alternative billing options for the services provided if the patient is responsible for payment.
What to Check
- The patient’s eligibility and benefits verification response.
- The insurance policy documents for premium payment requirements.
- The claim submission details to ensure accurate billing information was provided.