MA21Remark Code (RARC)Active
MA21 Remark Code - SSA Mismatch Explanation
The MA21 remark code indicates that there is a mismatch between the name and sex information on the claim and the records held by the Social Security Administration (SSA). This discrepancy can lead to issues with claim processing and payment, as the payer relies on accurate identification information.
How It Relates to the Denial
The MA21 remark code typically accompanies a Claim Adjustment Reason Code that indicates a denial or adjustment due to identification discrepancies. The combination signals that the payer has identified an issue with the patient's identifying information, which must be resolved for proper processing.
Common Scenarios
1A claim was submitted for a patient named Alex Smith, who identifies as male, but the SSA records list Alex as female. The claim is returned with an adjustment indicating an identification issue.
→ The MA21 remark code points to the mismatch in name and sex, suggesting that the payer needs correct identifying information to proceed with the claim.
2A provider bills for a service rendered to Jamie Taylor, but SSA records show a different name or gender associated with the same Social Security number. The remittance shows a denial with an accompanying reason code.
→ The MA21 remark code highlights the discrepancy in identifying information, indicating to the biller that the SSA records do not match the claim details.
3A claim for a procedure performed on a patient named Casey Jordan is denied due to a name and sex mismatch, as noted on the remittance advice.
→ The MA21 remark code serves as a clarification that the reason for the denial is the inconsistency between the claim submission and SSA records.
What to Do
- Verify the patient's name and sex against SSA records and correct any inaccuracies in the claim submission.
- Resubmit the claim with updated identifying information to resolve the mismatch indicated by the MA21 remark code.
- Communicate with the patient if necessary to confirm their correct name and sex as per SSA records.
What to Check
- Check the patient's name and sex in the billing system to ensure they match SSA records.
- Review the claim submission for any typographical errors in the patient's identifying information.
- Consult the SSA records, if accessible, to confirm the correct name and sex for the patient.