MA92Remark Code (RARC)Active
MA92 Remark Code - Missing Plan Information
The MA92 remark code indicates that there is missing plan information regarding other insurance coverage for the patient. This remark typically appears alongside an adjustment reason code that indicates a denial or reduction due to the absence of this critical information.
How It Relates to the Denial
The MA92 remark code usually accompanies adjustment reason codes that reflect denials or reductions in payment due to unreported or missing information about other insurance coverage. This combination signals that the payer requires additional details about secondary coverage to process the claim correctly.
Common Scenarios
1A claim for a surgical procedure was submitted for a patient who has multiple insurance plans, but the remittance returned with an adjustment indicating a denial due to lack of information about the secondary insurance.
→ The appearance of the MA92 remark code suggests that the payer is denying the claim partly because the billing office did not provide necessary details about the patient's other insurance plan, which is essential for determining the correct payment amount.
2An office visit claim was submitted, but the payer responded with a partial payment and the MA92 remark, indicating some information was missing.
→ In this case, the MA92 remark code indicates that the payer needs information about other insurance coverage that the patient may have, which could affect the payment calculation.
3A physical therapy claim was processed, and the remittance included a reason code for denial along with the MA92 remark code regarding insurance information.
→ The MA92 remark code here indicates that the claim's denial is due to insufficient information about the patient's other insurance, which the payer needs to proceed with the claim.
What to Do
- Contact the patient to gather details about any other insurance plans they may have.
- Include the missing plan information when resubmitting the claim to the payer.
- Ensure that all insurance policies are listed in the patient's record for future claims.
What to Check
- The patient's insurance information on file to verify any other coverage.
- The original claim submission to confirm that all relevant insurance details were included.
- The remittance advice for any accompanying reason codes that clarify the specific adjustment made.