N935Remark Code (RARC)ActiveInformational Alert
N935 Remark Code: Patient No Longer Medicaid Eligible
The N935 remark code indicates that the patient is no longer eligible for Medicaid or as a Qualified Medicare Beneficiary. This alert serves to inform providers that the patient's coverage status has changed, which may affect billing and reimbursement processes.
What This Alert Tells You
As an informational alert, N935 is not associated with any specific claim adjustment or denial. It is intended to notify providers of the patient's change in eligibility status without triggering a specific action or adjustment on the claim.
Common Scenarios
1A provider submits a claim for services rendered to a patient previously covered by Medicaid, and the remittance advice includes the N935 alert.
→ The N935 alert indicates that the patient's Medicaid status has changed, meaning the provider should verify the patient's current insurance coverage before resubmitting claims.
2A hospital receives an 835 remittance showing N935 for a patient who was a Qualified Medicare Beneficiary but has since lost that status.
→ This alert informs the hospital that they must check the patient's current coverage and adjust their billing practices accordingly.
3A claim is submitted for a routine check-up, and the payer returns the remittance with the N935 alert indicating no current Medicaid eligibility.
→ The N935 alert suggests that the patient should be checked for alternative coverage options before proceeding with further billing.
What to Do
- Do not resubmit the claim based solely on this alert.
- Verify the patient's current insurance status to determine the appropriate payer moving forward.
What to Check
- The patient's eligibility records to confirm their current insurance coverage.
- Any recent correspondence or notifications regarding the patient's Medicaid status.
- The insurance policy document to understand the implications of the change in eligibility.