MA94Remark Code (RARC)Active
MA94 Remark Code - Missing Hospice Employment Statement
The MA94 remark code indicates that the claim form did not include the statement 'Attending physician not hospice employee.' This statement is necessary to confirm that the rendering physician is not an employee of the hospice, impacting the appropriateness of the billed services.
How It Relates to the Denial
The MA94 remark code typically accompanies a Claim Adjustment Reason Code indicating a denial or adjustment related to hospice services. Together, they signal that the claim is incomplete due to missing certification regarding the physician's employment status.
Common Scenarios
1A hospice facility submits a claim for a patient's palliative care services, but the remittance response includes a denial for missing information.
→ The MA94 remark code points to the absence of the required statement about the attending physician's employment status, indicating that the claim cannot be processed without this clarification.
2A claim for home health services provided by a non-hospice physician is submitted, but the payer returns a denial with MA94 noted.
→ In this instance, the MA94 remark code signifies that the claim lacks the necessary declaration that the attending physician is not a hospice employee, which is crucial for reimbursement.
3An outpatient hospice service claim is denied, and the remittance shows MA94 as a supplemental remark code.
→ This indicates that the claim form did not include the statement about the attending physician's employment, leading to the claim's denial based on incomplete documentation.
What to Do
- Review the claim form to ensure the statement 'Attending physician not hospice employee' is included.
- If the statement is missing, amend the claim with the required certification and resubmit it to the payer.
What to Check
- The original claim form submitted to the payer for the attending physician's services.
- Payer guidelines regarding hospice services and required documentation for claims.
- The specific Claim Adjustment Reason Code associated with the MA94 remark to understand the context of the denial.