N360Remark Code (RARC)ActiveInformational Alert
N360 Remark Code - Coordination of Benefits Alert
The N360 remark indicates that coordination of benefits has not been calculated for the pre-determination process. This alert informs the biller that payment information from the primary payer is required when submitting a claim to the secondary payer.
What This Alert Tells You
The N360 remark is informational and typically appears with secondary claims that are submitted after a pre-determination. It serves as a reminder to include the primary payer's payment information to facilitate proper coordination of benefits.
Common Scenarios
1A provider submits a secondary claim for a patient who has dual coverage, but the primary payer's payment has not been included.
→ The N360 alert indicates that the secondary payer needs the primary payer's payment details to process the claim correctly.
2A pre-determination request was made for a procedure, but the provider received an N360 alert upon submitting the secondary claim.
→ The N360 alert signals that the provider must supply the primary payer's payment information to ensure the secondary claim can be evaluated for benefits.
3A claim for a service rendered to a patient with multiple insurance coverages comes back with an N360 alert after a pre-determination was issued.
→ The N360 alert highlights the necessity of including the primary payer's payment information for the secondary claim to proceed.
What to Do
- Do not resubmit the claim without primary payer payment information.
- Gather the payment details from the primary payer to include in the secondary claim submission.
What to Check
- The primary payer's remittance advice or explanation of benefits (EOB).
- The claim submission records to ensure the primary payment information is included.
- The pre-determination documentation to confirm the expected benefits and calculations.