Reason code N105 is a denial code indicating that a healthcare claim or service has been incorrectly directed and needs to be submitted to the appropriate carrier for a Railroad Retirement Board (RRB) beneficiary.
Understanding Denial Code N105
When you receive a denial with reason code N105, it means the claim was sent to the wrong payer. This particular code specifically points out that the service was for a beneficiary under the Railroad Retirement Board and should have been routed to their designated healthcare carrier.
Resolving Claims Denied with N105
To ensure proper processing and payment for services rendered to an RRB beneficiary, claims must be directed to the correct specific carrier. For beneficiaries under the Railroad Retirement Board, the designated carrier is Palmetto GBA.
Key Steps to Address N105 Denial:
- Identify the Correct Payer: The primary action is to recognize that the claim belongs to a Railroad Retirement Board beneficiary and must be sent to their specific carrier.
- Submit to Palmetto GBA: Ensure all future and resubmitted claims for these beneficiaries are directed to Palmetto GBA.
- Correct Mailing Address: For paper claims, the correct mailing address for Palmetto GBA is:
- P.O. Box 10066
- Augusta, GA 30999
Summary of N105 Details:
| Field | Detail |
|---|---|
| Code Type | Denial Code / Reason Code (RARC) |
| Primary Issue | Claim or service incorrectly directed |
| Intended Recipient | Railroad Retirement Board (RRB) beneficiary's specific carrier |
| Designated Carrier | Palmetto GBA |
| Paper Claim Address | P.O. Box 10066, Augusta, GA 30999 |
By understanding that N105 signals a misdirected claim for an RRB beneficiary, providers can quickly correct their submission process by sending the claim to Palmetto GBA, ensuring timely and accurate processing.
