N760Remark Code (RARC)Active
N760 Remark Code - Facility Not Authorized for Payment
The N760 remark code indicates that the facility is not authorized to receive payment for the billed services. This means that the payer has determined that the provider does not have the necessary credentials or agreements to bill for these services.
How It Relates to the Denial
The N760 code typically accompanies a Claim Adjustment Reason Code that indicates a denial or adjustment related to provider authorization. This combination signals that the service was not paid due to the facility's lack of authorization, requiring further investigation into the provider's credentials.
Common Scenarios
1A facility billed for outpatient surgery services, but the remittance received includes a denial indicating that payment is not authorized.
→ In this case, the N760 remark suggests that the payer has found the facility lacks the proper authorization to receive payment for the surgical services rendered.
2A claim for physical therapy services was submitted by a facility, and the remittance shows an adjustment stating payment will not be made.
→ Here, the N760 remark indicates that the facility is not recognized by the payer as eligible to bill for physical therapy services, implying a need to verify the facility's authorization status.
3A hospital submitted a claim for emergency room services, but the payment was denied with a remark indicating the facility's non-authorization.
→ The presence of the N760 remark means that the payer has deemed the hospital unauthorized to bill for those emergency services, necessitating a review of the facility's provider agreements.
What to Do
- Verify the facility's provider status with the payer to determine if it is authorized to bill for the services rendered.
- If the facility is supposed to be authorized, contact the payer to clarify the authorization issue and resolve it as needed.
- Review any contracts or agreements between the facility and the payer to ensure compliance with billing requirements.
What to Check
- The provider credentialing documents to confirm the facility's current authorization status.
- The contract terms with the payer to ensure the facility is permitted to provide the billed services.
- The remittance advice for the accompanying Claim Adjustment Reason Code that details the nature of the denial or adjustment.