N920Remark Code (RARC)Active
N920 Remark Code - Payment Hold Due to Contract Negotiation
The N920 remark code indicates that payment to the provider is currently on hold due to active contract negotiation. This situation signifies that the payer is in the process of renegotiating the terms of the provider's contract, which has resulted in a temporary hold on payments for services rendered.
How It Relates to the Denial
The N920 code typically accompanies a Claim Adjustment Reason Code that indicates a payment adjustment due to contract issues. The combination signals to the provider that while the claim was processed, payment has been delayed pending the outcome of contract negotiations.
Common Scenarios
1A provider submits claims for various services, but the remittance advice shows adjustments with the Claim Adjustment Reason Code indicating a reduction in payment due to contract issues.
→ In this scenario, the N920 remark code clarifies that the payment hold is specifically due to ongoing contract negotiations between the provider and payer.
2A facility bills for a series of outpatient procedures, and the remittance comes back with reduced payment and the N920 remark code attached.
→ The presence of the N920 code suggests that the payment hold is not due to billing errors but rather a consequence of contractual discussions that are currently taking place.
3A specialist provider receives an 835 remittance showing a claim denial with a reason code related to payment terms, along with the N920 remark code.
→ Here, the N920 remark indicates that the denial is tied to the active negotiation status of the provider's contract, further clarifying the reason for the payment hold.
What to Do
- Monitor the status of the contract negotiations with the payer.
- Do not attempt to resubmit the claims while the payment is on hold due to contract negotiations.
What to Check
- The contract status with the payer to understand ongoing negotiations.
- Communications from the payer regarding contract discussions and their impact on payments.
- The original claim submission details to ensure compliance with any existing agreements.