N696Remark Code (RARC)ActiveInformational Alert
N696 Remark Code: COB or TPL Recovery Alert
The N696 remark code indicates that the claim reversal is a result of a retroactive adjustment related to Coordination of Benefits (COB) or Third Party Liability (TPL) recovery. This alert serves to inform the provider that the adjustment is not linked to a specific denial or payment adjustment but is instead due to external factors affecting the claim's status.
What This Alert Tells You
The N696 remark code is typically seen in conjunction with claim reversals, signaling that the reversal is due to adjustments in COB or TPL recovery. This alert does not imply any action is required to correct a denial, as it solely provides information regarding the nature of the reversal.
Common Scenarios
1A provider receives an 835/ERA showing a reversal for a previously paid claim for a surgical procedure. The accompanying reason code indicates a retroactive adjustment.
→ The N696 remark code clarifies that the reversal is related to adjustments made after determining other insurance or liability coverage. The payer expects the provider to understand this is not a denial but a necessary adjustment.
2A claim for physical therapy services was initially paid but later reversed on the remittance advice due to new information about another payer's involvement.
→ With the N696 remark code present, the provider can see that the reversal is due to coordination of benefits rather than an issue with the claim's validity. This means the adjustment was made because of an update regarding third-party liability.
3A hospital receives a remittance notification indicating a reversal on a claim for inpatient services, citing the N696 alert.
→ The presence of the N696 remark code informs the hospital that this reversal stems from a retroactive adjustment related to other insurance, indicating that the claim's payment may change based on this new information.
What to Do
- Do not resubmit the claim as a correction is not needed for this alert.
- Monitor any potential changes regarding third-party liability or coordination of benefits that may affect future claims.
What to Check
- Review the claim's payment history to understand the nature of the reversal.
- Verify any coordination of benefits or third-party liability information that may have changed.
- Examine the remittance advice for any additional notes or instructions related to the claim reversal.