MA90Remark Code (RARC)Active
MA90 Remark Code - Employment Status Code Issue
The MA90 remark code indicates that the claim was denied due to a missing, incomplete, or invalid employment status code for the primary insured. This remark serves to clarify the reason code already provided on the remittance advice, pointing directly to an issue with the insured's employment status information.
How It Relates to the Denial
The MA90 remark code typically accompanies claim adjustment reason codes related to eligibility or incorrect information. This combination signals that the claim cannot be processed further due to insufficient employment status details for the primary insured.
Common Scenarios
1A claim was submitted for a primary insured who is a full-time employee, but the employment status was not indicated on the claim form.
→ The MA90 remark code suggests that the payer could not verify the primary insured's employment status, leading to the denial. The payer is indicating that this information is necessary for proper processing.
2A provider submitted a claim for a service rendered to a patient, but the remittance returned with an adjustment stating that the employment status code was invalid.
→ The presence of MA90 indicates that the payer found the employment status code provided was either missing or not recognized. The remark emphasizes the need for correct employment information.
3A claim for a dependent was denied, and the remittance showed an adjustment for eligibility with the MA90 remark attached.
→ In this case, MA90 indicates that the primary insured's employment status was not adequately reported, which affects the dependent's eligibility. The payer expects this information to be rectified.
What to Do
- Verify that the employment status code for the primary insured is included on the claim form.
- Correct any inaccuracies in the employment status code and resubmit the claim if necessary.
- Ensure that the employment status is valid as per the payer's requirements before submitting future claims.
What to Check
- The claim form submitted for the employment status code entry.
- The eligibility response for the primary insured to confirm their employment status.
- Payer guidelines for acceptable employment status codes to ensure compliance.