RARC N130: Consult plan benefit documents/guidelines for information about restrictions for this service.
There's a benefit restriction in the plan that applies — see the SBC.
What it means
The official X12 description: “Consult plan benefit documents/guidelines for information about restrictions for this service.”
In plain language: There's a benefit restriction in the plan that applies — see the SBC.
What to do
Read Summary of Benefits and Coverage. If you believe the restriction violates federal law (essential health benefits, parity), appeal.
Frequently asked questions
What does RARC N130 mean?
Consult plan benefit documents/guidelines for information about restrictions for this service. In plain language: There's a benefit restriction in the plan that applies — see the SBC.
What should I do when I see RARC N130?
Read Summary of Benefits and Coverage. If you believe the restriction violates federal law (essential health benefits, parity), appeal.
Commonly paired CARC codes
Sources
Contact: hello@approvalhelp.com