N701Remark Code (RARC)Active
N701 Remark Code - Value-based Payment Adjustment
The N701 remark code indicates that the payment has been adjusted due to the Value-based Payment Modifier. This adjustment reflects the provider's performance in relation to cost and quality metrics as defined by the payer.
How It Relates to the Denial
The N701 remark typically accompanies a Claim Adjustment Reason Code that indicates a payment reduction or adjustment. Together, these codes signal that the payment reflects a value-based assessment rather than a straightforward reimbursement.
Common Scenarios
1A provider submitted a claim for a series of outpatient services, and the remittance shows a payment reduction alongside a reason code for performance metrics.
→ The N701 remark clarifies that the reduction in payment is linked to the provider's performance under the Value-based Payment Modifier, indicating a quality and cost evaluation.
2A hospital received a remittance for a patient's inpatient stay, which included an adjustment for the total billed amount based on quality measures.
→ The N701 remark suggests that the payment adjustment was influenced by the hospital's adherence to the Value-based Payment Modifier criteria.
3A physician practice billed for preventive services and received a lower payment amount due to quality performance metrics outlined by the payer.
→ The N701 remark points out that the payment adjustment is a result of the Value-based Payment Modifier, reflecting the practice's performance in delivering care.
What to Do
- Review the accompanying Claim Adjustment Reason Code for details on the specific adjustment amount.
- Evaluate the provider's performance metrics related to the Value-based Payment Modifier to understand the basis for the adjustment.
- Consider contacting the payer for clarification on how the Value-based Payment Modifier impacted the payment.
What to Check
- The provider's performance score or metrics related to value-based care initiatives.
- The specific Claim Adjustment Reason Code that accompanies the N701 remark for more context.
- Any documentation or communications from the payer regarding Value-based Payment Modifier policies.