Understanding Remittance Advice Remark Code N598
The N598 denial code, often referred to as “Health care policy coverage is primary,” occurs when an insurer identifies another payer as primarily responsible for a claim. This issue arises due to discrepancies in primary and secondary insurance coverage information, leading to claim denials that impact the revenue cycle.
Healthcare providers encounter this denial frequently when incorrect or outdated insurance information is on file, resulting in confusion between payers. Preventing N598 denials requires precision in insurance management, coordination of benefits (COB), and proactive verification.
Common Causes of N598 Denials
- Incorrect Insurance Information: Errors in patient insurance data, such as outdated policies or missing details.
- Verification Oversights: Insufficient validation of coverage details, including policy numbers and the sequence of insurance.
- Premature Secondary Billing: Attempting to bill the secondary insurance before the primary payer processes the claim.
- Failure to Update Insurance Changes: Neglecting to update new insurance details when a patient’s coverage changes.
- COB Issues: Coordination of Benefits errors, such as another insurer being identified as primary.
- Communication Gaps: Poor communication between providers, billing departments, and insurers.
- Data Entry Errors: Even minor errors in patient data or insurance fields can result in denied claims.
Strategies to Prevent N598 Denials
- Thorough Insurance Verification: Confirm the patient’s insurance details, including policy numbers and payer order, during every visit.
- Accurate Data Management: Keep the Electronic Health Records (EHR) system up-to-date with current patient information.
- Ensure Data Entry Accuracy: Implement quality control measures to prevent typographical errors.
- Resubmit Corrected Claims: If denied due to N598, resubmit the claim promptly to the correct primary payer.
- Effective Documentation: Maintain detailed records of all communications and changes in patient insurance coverage.
- Stay Updated on Insurance Policies: Monitor insurance updates and educate staff on COB rules.
- Leverage Technology Tools: Use automated solutions for real-time insurance verification to avoid COB-related errors.
Partner with Claims Med for RCM Success
N598 denials can create unnecessary friction in your revenue cycle management (RCM), leading to payment delays and administrative burdens. At Claims Med, we specialize in helping healthcare providers reduce claim denials and streamline billing processes.
Want to optimize your practice’s billing and ensure smooth claim handling?
Contact Claims Med today to learn how our expert RCM solutions can help you avoid denials and boost your reimbursement.