N691Remark Code (RARC)ActiveInformational Alert
N691 Remark Code - Patient Appeal Reversal Alert
The N691 remark code indicates that a claim reversal has occurred due to an appeal submitted by the patient. This alert serves to inform the biller that the reversal is not a traditional denial but rather a result of the patient's action.
What This Alert Tells You
The N691 remark code is informational and typically appears with claim or service reversals. It does not indicate an adjustment but rather the reason behind the reversal, which is linked to a patient appeal.
Common Scenarios
1A claim for a surgical procedure was initially paid but later reversed, and the billing office receives the 835 with the N691 remark code.
→ In this case, the N691 remark code indicates that the reversal is related to an appeal made by the patient regarding the claim.
2A patient disputed a charge for an office visit, leading to the payer reversing the payment on the claim, accompanied by the N691 remark code on the remittance advice.
→ Here, the N691 remark code informs the biller that the payment reversal is due to the patient's appeal, not a billing error or payer denial.
3After a claim for a diagnostic test was processed, the payer issued a reversal with the N691 code due to a patient-initiated appeal.
→ The presence of the N691 remark code indicates that the payer is reversing the claim because of the patient's appeal, rather than any issue with the claim submission.
What to Do
- Do not take action to appeal or resubmit the claim based solely on this remark.
- Monitor the patient's appeal status for any updates that may affect the claim.
What to Check
- Review the patient’s appeal documentation to understand the reason for the reversal.
- Check the claim history for any notes regarding the patient's appeal and its outcome.
- Consult the payer's policy on how appeals may affect previously paid claims.