N874Remark Code (RARC)ActiveInformational Alert
N874 Remark Code: Payment through Negotiation Alert
The N874 remark code indicates that the final payment was established through open negotiation under the No Surprises Act. This alert serves as a notification to providers that the payment amount was not determined through the usual claims processing rules, but rather through a negotiated process.
What This Alert Tells You
The N874 alert is informational and does not accompany any specific adjustment or reason code. It highlights that the payment was reached through negotiations, aligning with the provisions of the No Surprises Act.
Common Scenarios
1A provider submits a claim for a high-cost service, and instead of the usual payment determination, the remittance shows the N874 remark code.
→ The presence of the N874 code signifies that the payment was settled through negotiation rather than standard processing, indicating compliance with the No Surprises Act.
2A facility receives payment for an emergency service rendered to a patient out-of-network, with the remittance including the N874 code.
→ This remark indicates that the payment was finalized through negotiations, reflecting the protections offered under the No Surprises Act.
3A provider is reviewing an 835 remittance for a procedure that typically has a set reimbursement rate, but the N874 code appears instead.
→ The N874 code informs the provider that this payment was negotiated, which deviates from the usual payment guidelines.
What to Do
- Do not take any specific action based on this alert; it is for informational purposes only. Expect that the payment has been finalized through negotiated terms.
What to Check
- Review the claim details to understand the context of the negotiated payment.
- Check the No Surprises Act documentation to familiarize yourself with its implications for payment negotiations.