lindam@caricures.com
Networker
I've been getting claim denials with the following remark codes - 16 - claim/service lacks information which is needed for adjudication. Claim submitted like we usually do. On the same claim - N521 MISMATCH BETWEEN SUBMITTED PROV INFO & PROV INFOR STORED IN SYSTEM. And N152 - Missing/incomplete/invalid replacement claim information. Again resubmitted like I usually do. This is a Horizon BCBSNJ plan that we submit to our local Highmark (PA). I wanted to ask on Availity about these messages, but I don't know what "reason for " code to use - if is more a question than anything. Any insight would be appreciated.