N147Remark Code (RARC)Active
N147 Remark Code - Patient ID Issues Affecting Rate
The N147 remark code indicates that the long term care case mix or per diem rate could not be established due to issues with the patient ID number. Specifically, it suggests that the patient ID is either absent, incomplete, or invalid on the assignment request, which is crucial for determining the appropriate rate.
How It Relates to the Denial
This remark code typically accompanies an adjustment reason code related to payment reductions or denials for long term care services. The combination signals that the claim adjustment is directly linked to the patient ID issue, impacting the calculation of the case mix or per diem rate.
Common Scenarios
1A facility submits a claim for long term care services but receives a remittance indicating payment was denied due to rate determination issues.
→ The N147 remark suggests that the denial is rooted in the unavailability or inaccuracy of the patient ID number, which is essential for calculating the correct reimbursement rate.
2A biller reviews a remittance for a long term care claim and sees an adjustment for a reduced payment, along with the N147 remark code.
→ This indicates that the payer could not finalize the rate for the services rendered because the patient ID was not properly provided, leading to the adjustment.
3A long term care provider receives a remittance stating that the claim is incomplete, accompanied by N147.
→ The remark highlights that the missing or invalid patient ID is the reason for the claim's incompleteness, hence affecting the rate determination.
What to Do
- Verify the patient ID number on the assignment request for completeness and accuracy.
- If the patient ID is missing, obtain the correct ID and resubmit the claim with this information.
- Correct any discrepancies in the patient ID details and ensure they match the payer's records before resubmission.
What to Check
- The assignment request document for the patient ID number.
- The claim submission records to ensure the patient ID was included and correct.
- Payer guidelines regarding patient ID requirements for long term care claims.