N687Remark Code (RARC)ActiveInformational Alert
N687 Remark Code - Alert on Retroactive Disenrollment
The N687 remark code indicates that a claim reversal has occurred due to a retroactive disenrollment of a patient from their health plan. This alert serves as a notification to the biller that the reversal is not the result of a billing error or adjustment, but rather a change in the patient's enrollment status.
What This Alert Tells You
The N687 alert typically appears in conjunction with claim or service reversals, signaling that the reversal is specifically linked to the patient's disenrollment. It is not associated with any financial adjustments or corrections to the claim itself.
Common Scenarios
1A provider submitted a claim for a service rendered to a patient, but the claim was later reversed, and the N687 remark appeared on the remittance advice.
→ The appearance of the N687 remark indicates that the claim reversal was due to the patient being retroactively disenrolled from their health plan, meaning the provider may not be reimbursed for the service.
2After billing for a procedure, the provider receives an 835 file with a reversal noted and the N687 remark included.
→ This remark informs the provider that the reversal is a result of the patient's disenrollment, not an issue with the claim itself.
3A claim for a scheduled follow-up visit is reversed on the remittance advice, with the N687 code noted alongside it.
→ The N687 remark clarifies that the reversal is due to the patient being disenrolled from their plan retroactively, indicating that the visit may not be covered.
What to Do
- Do not resubmit the reversed claim, as the N687 remark indicates it is due to disenrollment.
- Monitor the patient's enrollment status to avoid future issues with claims.
What to Check
- Check the patient's enrollment records to confirm their current status.
- Review any communications from the payer regarding the patient's disenrollment.
- Examine the original claim submission for accuracy and compliance with payer guidelines.