MA115Remark Code (RARC)Active
MA115 Remark Code - Missing HPSA Location Info
The MA115 remark code indicates that the claim has missing, incomplete, or invalid information regarding the physical location where the services were provided in a Health Professional Shortage Area (HPSA). This remark supplements an adjustment already noted by a Claim Adjustment Reason Code, clarifying that location details are necessary for the payer's processing of the claim.
How It Relates to the Denial
Typically, the MA115 remark accompanies adjustment reason codes related to claims being denied or reduced due to insufficient location information. It signals that a specific area of the claim needs attention regarding the service location's validity in relation to HPSA requirements.
Common Scenarios
1A provider submitted a claim for services rendered in a designated HPSA but received a denial for 'location not valid'.
→ The MA115 remark suggests that the claim lacks proper details about the physical location where the services were delivered, which the payer requires for processing.
2A claim for a rural health clinic was submitted, but the remittance shows a reduction due to an incomplete address for the service location.
→ The MA115 remark indicates that the payer found the location information insufficient or incorrect, impacting the claim's payment status.
3A specialist billed for a consultation in an HPSA and got back an adjustment stating the service location was invalid.
→ The MA115 remark points to the necessity of verifying the physical location details submitted with the claim to align with HPSA standards.
What to Do
- Verify the physical location details provided in the claim for accuracy and completeness.
- Ensure the name and address match the requirements for HPSA designation.
- If applicable, supply the Provider Identification Number (PIN) if it was omitted or incorrect.
What to Check
- The claim submission for the physical location name and address.
- The eligibility response to confirm HPSA designation for the location.
- The provider's documentation to ensure compliance with HPSA location requirements.