N187Remark Code (RARC)ActiveInformational Alert
N187 Remark Code: Review Request Instructions
The N187 remark code is an alert indicating that a provider may request a review in writing, following the specific instructions outlined in their contract or plan benefit documents. This notice serves to inform you of the option to seek further clarification or appeal within the required time limits after receiving this alert.
What This Alert Tells You
The N187 alert is informational and does not accompany any specific adjustments or reason codes. It acts as a reminder of the processes available to providers for requesting reviews regarding decisions made by the payer.
Common Scenarios
1A provider receives an 835/ERA that includes the N187 remark after submitting a claim for a service that was denied for reasons not specified in the remittance advice.
→ The N187 remark indicates that the provider has the right to request a review of the denial, provided they follow the instructions in their contract or benefit documents.
2After billing for a series of services, a provider sees the N187 remark on their remittance advice, but there are no adjustments related to the claim.
→ The presence of the N187 alert suggests that while there are no immediate adjustments, the provider should be aware of their right to request a review regarding any aspect of the notice received.
3A provider notices the N187 alert on their remittance advice following a claim submission for a high-cost procedure that was partially paid.
→ The N187 alert signals that the provider can pursue a review regarding the payment decision by adhering to the guidelines specified in their contract or plan documents.
What to Do
- Review your contract or plan benefit documents for instructions on how to request a review in writing.
- Prepare and submit the request for review according to the specified guidelines and time limits outlined in your contract.
What to Check
- Your contract or plan benefit documents for review request procedures.
- The remittance advice for any additional notes or instructions related to the N187 alert.
- The timeline for submitting a review request as indicated in your contract or plan documents.