N127Remark Code (RARC)Active
N127 Remark Code - Misdirected Claim for UMWA
The N127 remark code indicates that the claim or service was misdirected and should have been submitted to the United Mine Workers of America (UMWA) for processing. This remark supplements a claim adjustment reason code, clarifying that the payer is not responsible for the payment due to the incorrect routing of the claim.
How It Relates to the Denial
The N127 remark typically accompanies claim adjustment reason codes that denote claim denials or rejections based on improper submission channels. This combination signals that the claim was not processed because it was sent to the wrong payer, specifically indicating UMWA as the correct entity.
Common Scenarios
1A provider submits a claim for a patient who is a UMWA beneficiary, but the claim is sent to a commercial insurer instead. The remittance response includes the N127 remark code.
→ In this scenario, the N127 remark informs the provider that the claim was not processed because it was misdirected to the wrong payer, and the provider needs to resubmit it to UMWA.
2A healthcare facility bills for services rendered to a UMWA member, but the payment comes back denied with N127 on the remittance advice. The accompanying reason code indicates the claim was not payable.
→ This indicates that the payer is not liable for the claim because it was incorrectly sent to them instead of UMWA, thus requiring a resubmission to the proper payer.
3A physician bills a service under a UMWA patient's insurance, receiving a remittance that includes N127 alongside a reason code for denial. The claim is marked as misdirected.
→ The N127 remark points out that the claim should have been sent to UMWA, and the physician must redirect the submission accordingly.
What to Do
- Resubmit the claim to the United Mine Workers of America (UMWA).
- Verify that the patient is indeed a UMWA beneficiary before resubmission.
What to Check
- Patient eligibility records to confirm UMWA coverage.
- Claim submission details to ensure proper routing to UMWA.
- The original claim to ensure that all information aligns with UMWA's requirements.