MA07Remark Code (RARC)ActiveInformational Alert
MA07 Remark Code - Claim Forwarded to Medicaid Alert
The MA07 code indicates that the claim information has been sent to Medicaid for review. This alert serves as a notification to providers that a secondary review is pending, which may affect claim processing outcomes in the future.
What This Alert Tells You
The MA07 alert is informational and does not accompany any specific adjustment or denial reason code. It simply indicates that the payer has forwarded the claim to Medicaid, which may be a routine part of the review process for certain claims.
Common Scenarios
1A provider submits a claim for a patient who is dually eligible for Medicare and Medicaid. The claim comes back with the MA07 alert noted in the remittance advice.
→ In this case, the MA07 alert signals that the payer has forwarded the claim information to Medicaid for further review, which may delay final payment or require additional documentation.
2A facility bills for a service provided to a patient who is covered by both a commercial plan and Medicaid, and the claim response includes the MA07 alert.
→ This alert indicates that the payer is coordinating with Medicaid regarding the claim, suggesting that the facility may need to await Medicaid's input before proceeding with the claim.
3A claim for a specific treatment is submitted for a patient with Medicaid eligibility, and the remittance advice shows the MA07 alert without any payment adjustment.
→ This suggests that while no immediate payment is made, the claim is under review by Medicaid, and the provider should be aware of potential changes pending the outcome of that review.
What to Do
- Do not take any immediate action regarding the claim; this is an informational alert only.
- Monitor the status of the claim for any updates from Medicaid that may affect processing.
What to Check
- Review the original claim submission for details on services rendered and patient eligibility.
- Check any correspondence from Medicaid if applicable, to see if additional information is requested.
- Keep an eye on future remittance advices for updates regarding the claim status.