RARC N127: Resubmit Claim to UMWA Health Plan
This claim was sent to the wrong payer — the patient is a UMWA health plan beneficiary, so redirect the claim to the United Mine Workers of America health plan.
What Does RARC N127 Mean?
RARC N127 is a routing code indicating that the claim was submitted to a payer that cannot process it because the patient's coverage is through the United Mine Workers of America (UMWA) Health and Retirement Funds. The UMWA health plan is a separate entity that processes its own claims, and other payers — including Medicare in certain coordination-of-benefits scenarios — will reject claims that belong to UMWA with this code.
This situation typically arises when the patient's insurance information in the billing system points to the wrong payer, or when the billing team is unaware that the patient has UMWA coverage. UMWA beneficiaries include current and retired coal miners and their dependents, and the plan has its own claims submission requirements, provider networks, and adjudication rules.
N127 is not a coverage denial — it is purely a misdirected claim. The service may be fully covered under the UMWA plan, but the claim needs to be sent to the correct processor to find out.
What to Do
Obtain the correct claims submission address and payer ID for the UMWA Health and Retirement Funds. Update the patient's insurance information in your billing system to reflect UMWA as the appropriate payer. Resubmit the claim to the UMWA health plan using their required claim format and submission method.
If you are unsure whether the patient's primary coverage is UMWA or another plan, verify with the patient directly and check for coordination of benefits. Some UMWA beneficiaries also have Medicare, and the order of payer responsibility depends on the patient's specific coverage situation. Contact the UMWA plan directly if you need clarification on their billing requirements or payer ID for electronic submissions.
Common Scenarios
- A retired miner's claim is submitted to Medicare, but the patient's UMWA health plan is actually the primary payer
- The patient provided a Medicare card at registration but did not mention their UMWA coverage, leading to the claim being sent to the wrong payer
- A hospital bills a commercial payer listed in the patient's file, but the patient's active coverage is through the UMWA health plan
- Claims for a UMWA beneficiary's dependent are submitted to the wrong payer because the dependent's insurance was recorded incorrectly during intake
Commonly Paired With
No common pairings documented yet.