N866Remark Code (RARC)ActiveInformational Alert
N866 Remark Code: No Surprises Act Alert
The N866 code indicates that the claim is subject to the No Surprises Act provisions, specifically regarding services provided by nonparticipating air ambulance providers. This alert is informational and does not imply any adjustment to the claim.
What This Alert Tells You
The N866 alert typically accompanies claims for air ambulance services rendered by nonparticipating providers. It serves to inform billers that specific regulatory protections under the No Surprises Act may apply, affecting how the claim is processed or paid.
Common Scenarios
1A claim for air ambulance transport was submitted for a patient who was transported by a nonparticipating provider.
→ The N866 alert indicates that this claim falls under the No Surprises Act, which may provide the patient with certain protections against unexpected medical bills.
2An air ambulance service billed for a transport where the provider does not have a contract with the patient's insurance plan.
→ Receiving the N866 alert means that the claim is subject to regulations that may affect the patient's cost-sharing responsibilities and the overall payment process.
3A provider submits an air ambulance claim and receives an 835/ERA that includes the N866 remark code.
→ This alert implies that the claim is being processed under the guidelines of the No Surprises Act, relevant for nonparticipating providers.
What to Do
- Do not take any specific action based on the N866 alert; it is for informational purposes only.
- Continue to monitor the claim for payment and any further communications from the payer.
What to Check
- Review the claim details to confirm the provider's participation status in the patient's insurance plan.
- Check the patient's eligibility response to understand their coverage for air ambulance services.
- Keep abreast of updates regarding the No Surprises Act that may impact future claims.