N870Remark Code (RARC)ActiveInformational Alert
N870 Remark Code - No Surprises Act Cost Sharing Alert
The N870 alert indicates that, under the No Surprises Act, the cost sharing for the service was calculated based on the billed amount, which was lower than the qualifying payment amount. This alert serves to inform providers that their billed charges were considered in the cost-sharing calculation, rather than the potentially higher qualifying payment amount.
What This Alert Tells You
The N870 alert typically appears alongside other reason codes and is purely informational. It does not indicate any adjustments or denials but rather clarifies the basis for the cost-sharing calculation as per regulatory requirements.
Common Scenarios
1A provider submits a claim for a service rendered, billing $200, while the qualifying payment amount is $250. Upon receiving the remittance advice, the provider sees the N870 alert.
→ The N870 alert informs the provider that the patient's cost sharing was determined using the billed amount of $200, which was less than the qualifying payment amount of $250. The provider should understand that this is compliant with the No Surprises Act.
2A facility bills $150 for an emergency service, and the qualifying payment amount is $175. The remittance advice received includes the N870 alert.
→ This alert indicates that the cost sharing applied to the patient was based on the billed amount of $150, which is lower than the qualifying payment amount of $175. The facility should recognize this as standard practice under the No Surprises Act.
What to Do
- Do not resubmit the claim; the N870 alert is informational only.
- Review the cost-sharing amounts applied to the patient as they reflect the billed amount.
What to Check
- Verify the billed amount on the claim submitted to ensure accuracy.
- Check the qualifying payment amount from the payer’s guidelines to compare with the billed amount.
- Review the No Surprises Act guidelines for further understanding of cost-sharing calculations.