Are claims denials affecting your bottom line due to the confusing “Denial Code 192: Non-standard adjustment code from paper remittance advice”? This code can be particularly frustrating for practice managers, healthcare providers, and business owners since it often points to coordination issues or outdated processes. In this post, we’ll help you understand Denial Code 192, explore its root causes, and provide practical solutions to reduce its impact on your revenue cycle.
What is Denial Code 192?
Denial Code 192 usually signals coordination of benefits (COB) issues between primary and secondary payers. It often appears in paper-based remittance advice, which may lack standardized adjustment codes, unlike electronic transactions (such as 837 files).
Common Causes of Denial Code 192
- Non-Standard Adjustment Code: The paper remittance uses a code that doesn’t align with standard Claims Adjustment Reason Codes (CARC).
- Coordination of Benefits (COB) Issues: The payer needs to communicate COB details with another insurance carrier.
- Manual Claim Processing: Denials may indicate reliance on manual systems instead of automated electronic remittance.
- Documentation Errors: Incomplete or inaccurate patient or provider data can trigger denials.
- Coding Issues: Errors in claim coding, especially those related to COB, may cause rejections.
- Payer Policy Misalignment: Policy discrepancies between payers and providers often result in rejected claims.
Best Practices to Address Denial Code 192
- Thorough Review of Remittance Advice: Carefully inspect the paper remittance to understand the exact reason behind the denial.
- Verify COB Information: Ensure the secondary payer details and patient insurance coverage are complete and accurate.
- Map Non-Standard Codes: Whenever possible, convert non-standard adjustment codes into standard CARC codes for smoother processing.
- Analyze Claim Documentation: Double-check medical records and supporting claim documents to catch discrepancies or missing data.
- Upgrade Your Claims Management System: Consider modernizing your billing platform to handle electronic remittances and reduce reliance on manual processes.
- Monitor Payer Policy Updates: Stay on top of policy changes from your payers to ensure compliance with submission guidelines.
- Communicate with Payers: Reach out directly to payers for clarification if the denial reason is unclear or unjustified.
Partner with Claims Med to Optimize Your Revenue Cycle
Tired of dealing with Denial Code 192 and other claim rejections? At Claims Med, our Revenue Cycle Management (RCM) experts can help you reduce denials, streamline claim processing, and improve collections. We offer tailored solutions to meet your practice’s unique needs, ensuring fewer denials and more efficient revenue cycles.
Let’s minimize denials together! Get in touch with Claims Med today to take your revenue cycle management to the next level.