You May Need to Resubmit These Claims to Novitas

Novitas Solutions, Texas’ Medicare payer, has discovered that a recent batch of “additional development request” letters, intended for Medicare claims with National Provider Identifier-related problems, weren’t mailed to physicians and others.

This oversight affects claims submitted between Oct. 5, 2016, and Dec. 2, 2016; these claims would have been rejected for no response to the development letter. To determine if any of your claims were rejected under this situation, review your explanation of benefits/remittance advice for these code pairs:

Pair One

  • CARC 16: Claim/service lacks information or has submission/billing error(s) which is needed for adjudication   
  • N257: Missing/incomplete/invalid billing provider/supplier primary identifier

Pair Two

  • N290: Missing/incomplete/invalid rendering provider primary identifier
  • N211: Alert: You may not appeal this decision, please resubmit your claim.

If you identify a claim you believe was rejected incorrectly for these reasons, resubmit it.

If you have questions, contact Novitas at (855) 252-8782. If you need help, contact TMA's reimbursement specialists at paymentadvocacy@texmed.org, or call the TMA Knowledge Center at (800)880-7955 and ask to speak to a reimbursement specialist.

Published Dec. 16, 2016

TMA Practice E-Tips main page

Last Updated On

December 19, 2016

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