M32Remark Code (RARC)ActiveInformational Alert
M32 Remark Code - Conditional Payment Alert
The M32 alert indicates that a conditional payment has been made while awaiting a decision from the patient's primary payer. This payment is not final and may require a refund if you receive further payment for the same service from another payer.
What This Alert Tells You
The M32 alert is informational and does not accompany any specific adjustment or reason code. It serves to notify the provider about the conditional nature of the payment made for the service rendered.
Common Scenarios
1A provider bills for a procedure and receives a partial payment from a secondary payer, along with an M32 alert on the remittance advice.
→ The M32 alert suggests that the payment received is conditional and that further action may be necessary if the primary payer issues a payment for the same service.
2A claim for a patient's visit is processed, and the provider sees an M32 alert stating a conditional payment has been made.
→ The M32 alert indicates that the payment is provisional, pending the primary payer's determination, and may require a refund if additional payment is received.
3A provider receives an 835 remittance for a service with an M32 alert indicating a conditional payment status.
→ The M32 alert informs the provider that they must monitor for any further payments from the primary payer and be prepared for a potential refund.
What to Do
- Monitor for any additional payments on the same service from the primary payer.
- Contact your billing office immediately upon receipt of any new payment for the service to determine the next steps regarding the conditional payment.
What to Check
- The remittance advice for any additional payments received for the same service.
- The patient's primary payer's policy regarding conditional payments.
- Any communication from the primary payer regarding their decision on the service in question.