N587Remark Code (RARC)Active
N587 Remark Code - Policy Benefits Exhausted
The N587 remark code indicates that the policy benefits for the services billed have been exhausted. This means that the patient has reached their limit for coverage under their insurance policy for the specific services provided.
How It Relates to the Denial
The N587 remark code typically accompanies adjustment reason codes that reflect a denial due to benefit exhaustion. Together, they signal to the biller that the claim cannot be paid because the patient's policy no longer covers the billed services.
Common Scenarios
1A provider submitted a claim for physical therapy services, but the payment was denied with an adjustment reason code indicating benefit exhaustion.
→ The N587 remark code clarifies that the patient has used up all available benefits for physical therapy, and no further coverage is applicable.
2A claim for a surgical procedure was submitted, but the remittance included an adjustment reason code for denial along with the N587 remark code.
→ This suggests that the patient has exhausted their surgical benefits, and the claim cannot be processed for payment.
3A patient received multiple office visits within a policy year, but the claim for the last visit was denied with an accompanying N587 remark code.
→ The remark indicates that the patient’s policy benefits for office visits have been fully utilized, resulting in a denial.
What to Do
- Verify if the patient has any remaining benefits under their policy for the services rendered.
- Consider discussing payment options with the patient, as the claim will not be covered due to exhausted benefits.
- Do not resubmit the claim unless there is new information regarding the patient's benefits.
What to Check
- The patient's policy benefit document to confirm coverage limits and exhaustion dates.
- The eligibility response to ensure the patient was active and had benefits at the time of service.
- The previous claims history to assess how many benefits have been utilized for the service type in question.