N192: Alert: Patient is a Medicaid/Qualified Medicare Beneficiary
This is an informational flag telling the provider that the patient is enrolled as a Qualified Medicare Beneficiary (QMB) or dual-eligible Medicaid recipient, which has billing implications for cost sharing.
Corrective actions
- 1
Check QMB billing restrictions before billing the patient
Federal law prohibits providers from billing QMB patients for Medicare deductibles, coinsurance, or copays; verify QMB status in the Medicare eligibility system before sending a patient statement.
- 2
Bill Medicaid for crossover cost sharing
Route the applicable cost-sharing amount to the state Medicaid program as a crossover claim instead of billing the patient directly.
Frequently asked questions
What does remark code N192 mean?
This is an informational flag telling the provider that the patient is enrolled as a Qualified Medicare Beneficiary (QMB) or dual-eligible Medicaid recipient, which has billing implications for cost sharing.
Retrieved 2026-07-18.
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Denial7 provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.