N373Remark Code (RARC)Active
N373 Remark Code - Incorrect Primary Payer Adjustment
The N373 remark code indicates that the payer has identified an error where another payer incorrectly processed a claim as primary. Consequently, they are issuing a refund to the correct payer, which reflects the adjustment already noted by the accompanying reason code.
How It Relates to the Denial
This remark typically accompanies claim adjustment reason codes that indicate an overpayment or an incorrect primary payer determination. The combination signals that a refund process is being initiated due to prior misidentification of the primary payer.
Common Scenarios
1A provider submitted a claim for a patient covered by two insurance plans, billing the secondary payer first. The remittance shows an adjustment for an overpayment along with the N373 remark.
→ In this case, the N373 remark clarifies that the secondary payer mistakenly paid as the primary, leading to a refund to the correct primary payer.
2A claim was submitted to a payer that should have been billed to a different primary insurer. The remittance advises an adjustment with the N373 code following a claim adjustment reason code for a payment error.
→ Here, the N373 remark indicates that the payer is refunding the amount paid because they were not the primary payer for the services rendered.
3A provider received a remittance for a service where the initial claim was processed incorrectly, listing the wrong primary payer. The N373 remark appears alongside an adjustment reason code for payment denial.
→ The N373 remark explains that the payer is correcting the payment error by refunding the amount to the original payer that was incorrectly listed as primary.
What to Do
- Verify the claim details and payment history related to the services in question.
- Ensure that the correct primary payer information is on file for future claims.
- Coordinate with the payer to clarify the refund process and any necessary documentation.
What to Check
- The claim submission details to confirm the correct primary payer.
- The remittance advice for the accompanying reason code and adjustment details.
- Any correspondence from the primary payer regarding payment responsibilities.