N697Remark Code (RARC)ActiveInformational Alert
N697 Remark Code - Alert on Retroactive Contract Adjustment
The N697 remark code indicates that a reversal has occurred due to a retroactive adjustment related to the payer's contract incentive program. This alert is purely informational and does not indicate any specific adjustment to the claim or payment.
What This Alert Tells You
The N697 remark is used in scenarios where a claim or service has been reversed as part of a retroactive adjustment process. It serves as a notification for billers regarding the nature of the reversal but does not accompany any specific adjustment or denial reason code.
Common Scenarios
1A provider receives an 835 remittance that includes a reversal for a previously paid claim under a contract incentive program.
→ The N697 remark informs the provider that the reversal is due to the payer's retroactive contract incentive program, indicating that the claim was re-evaluated under the terms of that program.
2A billing office processes a payment that has been reversed on a claim submitted for a service rendered last year, and the remittance shows the N697 code.
→ The presence of the N697 remark alerts the billing office that the reversal is tied to a program adjustment from the payer, rather than a billing error or denial.
3A healthcare facility receives an ERA with a reversal noted for a service under a specific incentive program, showing N697 as part of the explanation.
→ In this case, the N697 remark clarifies that the reversal is part of an incentive program's adjustments, and no further action is required for this specific reversal.
What to Do
- Do not take any action to resubmit the claim; this is simply an informational alert.
- Keep the N697 remark in mind for future reference regarding the payer's incentive program adjustments.
What to Check
- Verify the claim details to understand the context of the reversal.
- Review any contract agreements with the payer to assess how the incentive program may affect past claims.
- Check for any communication from the payer regarding changes in incentive program policies that may apply to this reversal.