M38Remark Code (RARC)ActiveInformational Alert
M38 Remark Code - Patient Liability Alert
The M38 alert informs the biller that the patient is financially responsible for the charges associated with this service. This situation arises when the patient was informed in writing prior to the service that payment would not be covered, and they agreed to take on the charges.
What This Alert Tells You
The M38 alert is purely informational and does not correspond to any specific adjustment or denial. It serves to clarify the patient's financial responsibility based on prior communication regarding service coverage.
Common Scenarios
1A patient received a non-covered elective procedure and was informed beforehand that their insurance would not pay for it.
→ In this case, the M38 alert indicates that the patient was made aware of their liability for the charges before the service was provided, confirming their agreement to cover the costs.
2A service was billed for a treatment deemed not medically necessary, and the patient signed a waiver acknowledging their financial responsibility.
→ The M38 alert reinforces that the patient acknowledged in writing their liability for the service costs, aligning with the prior notice of non-coverage.
3A patient received a cosmetic service and was informed in writing that it would not be covered by their insurance plan.
→ The M38 alert indicates that the patient was properly informed of their financial responsibility before the service, confirming that they agreed to pay the charges.
What to Do
- Do not take any action to resubmit the claim; the alert is for informational purposes only.
- Ensure that all patient communication regarding financial responsibility is documented appropriately.
What to Check
- Review the patient’s signed acknowledgment of liability for the charges.
- Check the written notice provided to the patient regarding coverage and payment responsibilities.
- Confirm that the service was clearly identified as non-covered in the patient’s documentation.