Alert: Records indicate new patient
Reviewed by
Medical Billing Compliance Team
Healthcare Revenue Cycle and Claims Processing Specialists
Last reviewed: February 5, 2026
📋 Official X12 Definition
RARC N116: Alert: Records indicate new patient. This remittance advice remark code is maintained by X12 as part of the standardized code set for providing supplemental information about claim adjustments.
💬 What This Means (Plain English)
This is an informational alert: Records indicate new patient. RARC codes that begin with "Alert" are providing you with important information about how the claim was processed or what you should be aware of going forward.
📖 Detailed Explanation
RARC Code N116 (Alert: Records indicate new patient) is a Remittance Advice Remark Code maintained by X12 as part of the standardized code set required for HIPAA-compliant electronic healthcare transactions. While CARC (Claim Adjustment Reason Codes) explain WHY a claim was adjusted, RARC codes provide supplemental information about HOW to resolve issues, what actions to take, or alert you to important processing details. This particular code is an "Alert" type RARC, meaning it's providing you with important informational context about the claim processing. Alert codes typically don't require immediate corrective action but give you valuable information for understanding the adjudication or for future claim submissions. Pay attention to these alerts as they can help you avoid future denials and improve your billing practices.
🔍 Common Causes
- Claim processed with special circumstances requiring notification
- Payer policy or procedure applied to claim
- Information relevant to future claim submissions
- Notification of patient status or eligibility details
- Processing completed with non-standard handling
✅ Step-by-Step Solution
Review Alert Details
Read the alert message carefully to understand what information the payer is providing about this claim or future submissions.
Assess Impact
Determine if this alert affects: this claim only, future claims for this patient, all claims of this type, or your practice's billing procedures.
Take Note for Future
Document this alert in your billing procedures or patient account notes so the information is available for future reference.
Update Processes if Needed
If the alert indicates a new requirement or process, update your billing workflows, staff training, or system configurations accordingly.
📋 Evidence & Documentation Checklist
📞 Insurance Company Call Script
Use these specific questions when contacting the payer:
- I'm calling regarding claim [CLAIM NUMBER] which received RARC code N116: Alert: Records indicate new patient. Can you provide additional context?
- Can you explain exactly what this remark code means in the context of this specific claim?
- What specific action, if any, do I need to take to resolve this?
- Is there additional documentation or information you need from me?
- What is the timeframe for any required response or action?
- Can you provide written clarification or send me a reference to the policy this code relates to?
- Is there a reference number for this call I can document?
🛡️ Prevention Tips
- Review all RARC codes on remittance advice, not just CARC codes
- Keep an updated reference guide of common RARC codes
- Train billing staff to understand RARC vs. CARC differences
- Document learnings from RARC codes to improve future submissions
❓ Frequently Asked Questions
What does RARC code N116 mean?
This is an informational alert: Records indicate new patient. RARC codes that begin with "Alert" are providing you with important information about how the claim was processed or what you should be aware of going forward.
What should I do when I receive RARC N116?
Review Alert Details: Read the alert message carefully to understand what information the payer is providing about this claim or future submissions.
How can I prevent RARC N116 in the future?
Key prevention strategies include: Review all RARC codes on remittance advice, not just CARC codes; Keep an updated reference guide of common RARC codes; Train billing staff to understand RARC vs. CARC differences.
What are common causes of RARC N116?
Common causes include: Claim processed with special circumstances requiring notification; Payer policy or procedure applied to claim; Information relevant to future claim submissions.
Sources & Attribution
- X12 External Code List - RARC (Remittance Advice Remark Codes) Version 34.0
- CMS Remittance Advice Remark Code (RARC) List
- CAQH CORE Operating Rules for Healthcare Claims
- HIPAA Transaction Standards - ASC X12N 835
Last Updated: July 1, 2025
Update Cycle: Quarterly (March, July, November)
⚠️ Important Disclaimer
This information is provided for educational purposes only and should not be considered medical, billing, or legal advice. Always verify code interpretations with the specific payer and consult with qualified billing professionals. Code definitions, policies, and payer-specific guidelines may vary and are subject to change without notice. For the most current information, always refer to the latest X12 External Code List and payer-specific policies.