N882Remark Code (RARC)ActiveInformational Alert
N882 Remark Code - Out-of-Network Payment Alert
The N882 code indicates that the out-of-network payment and cost-sharing amounts are calculated based on the plan's allowance because the provider obtained the patient's consent to waive balance billing protections under the No Surprises Act. This alert serves to inform that the payment determination has been made under specific consent conditions, rather than standard billing protections.
What This Alert Tells You
As an informational alert, the N882 code is not tied to any specific adjustment or denial reason code. It is intended to clarify the circumstances surrounding out-of-network payments when a patient has consented to waive their balance billing protections.
Common Scenarios
1A patient received care from an out-of-network provider and was billed for the services rendered. The claim processed with the N882 alert indicating the payment was based on the plan's allowance due to the patient's consent.
→ In this case, the N882 code signals that the payment calculation follows the plan's allowance because the patient agreed to waive protections against balance billing, which is a key detail for understanding the financial responsibility.
2An emergency room visit was billed by an out-of-network facility, and the N882 alert appeared on the remittance advice. The facility had obtained consent from the patient to waive balance billing protections.
→ Here, the N882 alert indicates that the payment amount reflects the plan's allowance under the No Surprises Act, highlighting the consent aspect that affects the patient's financial liability.
3A surgical procedure performed by an out-of-network surgeon resulted in payment processing showing the N882 alert. The surgeon documented that the patient consented to waive balance billing protections prior to the procedure.
→ The presence of the N882 alert means the payment and cost-sharing amounts are determined based on the plan's allowance due to the patient's consent, which is essential for understanding the patient's responsibilities.
What to Do
- Do not resubmit the claim based on this alert, as it is informational only.
- Review the patient's consent documentation to ensure it aligns with the No Surprises Act requirements.
What to Check
- The patient's signed consent form regarding balance billing protections.
- The claim submission details to confirm that the patient's consent was documented prior to service.
- The payer's remittance advice for additional context on payment calculations.