• New Remark Codes for QMB Status


    Some patients with dual eligibility are not responsible for any payment other than what Medicare or Medicaid provides. They have Qualified Medicare Beneficiary (QMB) status.

    To help clarify if a patient has QMB status, Medicare has updated new remittance advice remark codes. You can submit claims to another payer; however, these codes indicate that the patient is not responsible for any out-of-pocket expense.

    • N781 - Alert: Patient is a Medicaid/Qualified Medicare Beneficiary. Review your records for any wrongfully collected deductible. This amount may be billed to a subsequent payer.
    • N782 – Alert: Patient is a Medicaid/Qualified Medicare Beneficiary. Review your records for any wrongfully collected coinsurance. This amount may be billed to a subsequent payer.

    Watch your remittance advice closely as Medicare is seeing an increase in patients being billed when they have QMB status. Reimburse the patient if any payment has been made.