N105Remark Code (RARC)Active
N105 Remark Code - Misdirected Claim for RRB Beneficiary
The N105 remark code indicates that the claim or service submitted was misdirected for a Railroad Retirement Board (RRB) beneficiary. It specifies that claims for RRB beneficiaries must be submitted to the RRB carrier, specifically Palmetto GBA, using paper claims instead of electronic submissions.
How It Relates to the Denial
The N105 remark typically accompanies a claim adjustment reason code that indicates a claim was denied due to being sent to the wrong payer. The combination signals that the claim needs to be redirected to the appropriate RRB carrier for processing.
Common Scenarios
1A provider submitted a claim for an RRB beneficiary to a Medicare payer, expecting reimbursement.
→ The N105 remark suggests that the claim was not processed because it was sent to the incorrect party, and the provider needs to redirect it to Palmetto GBA.
2A billing office receives a remittance for a denied claim that includes the N105 remark after submitting an electronic claim for a service rendered to an RRB beneficiary.
→ This remark indicates that the claim must be submitted on paper to the RRB carrier, highlighting the need to follow the specific submission guidelines for RRB beneficiaries.
3An office receives a denial with the N105 remark after attempting to bill a service for a retired railroad employee.
→ The N105 remark clarifies that the claim was misdirected and must be resubmitted on paper to the appropriate RRB carrier for consideration.
What to Do
- Submit the claim on paper to the RRB carrier, Palmetto GBA.
- Ensure that all necessary documentation is included with the paper claim submission.
What to Check
- Verify the beneficiary's status to confirm they are an RRB beneficiary.
- Check the prior claims history to ensure that the claim was not previously submitted electronically.
- Review the payer's policy on submitting claims for RRB beneficiaries.