RARC N588: Patient Directed Claims Not Be Processed
The patient has directed the payer not to process this claim — contact the patient to confirm the directive and discuss the financial implications.
What Does RARC N588 Mean?
RARC N588 indicates that the patient has instructed the insurance company not to process claims or payments for their medical services. This is an unusual situation that reflects the patient's explicit decision to prevent insurance processing, which may stem from privacy concerns, a dispute with the insurer, or a preference to pay out of pocket.
Patients sometimes take this step when they want to keep certain treatments confidential — for example, mental health services, substance abuse treatment, or sensitive medical conditions that they do not want reflected in insurance records. In other cases, the directive may result from a disagreement with the payer about coverage terms or a desire to avoid accumulating claims against a lifetime benefit maximum for a particular service.
This denial is distinct from standard coverage denials because the payer is not making a determination about the claim's validity. The claim is simply not being processed at the patient's request. The payer cannot override this directive without the patient's consent.
What to Do
Contact the patient to confirm that the directive is intentional and currently active. Document the conversation, including the patient's stated reason and their understanding that they will be financially responsible for the full cost of services. Obtain a written acknowledgment from the patient if possible.
If the patient wants to reverse the directive, they will need to contact the payer directly to remove the hold on claims processing. Once the payer confirms the directive has been lifted, resubmit the affected claims. If the patient maintains their decision, bill the patient directly for the services. Update the patient's account in your billing system to reflect the self-pay arrangement and ensure future services are billed accordingly until the patient changes their instructions.
Common Scenarios
- A patient receiving mental health treatment requests that claims not be submitted to their insurance to maintain privacy
- A patient in a dispute with their insurance company directs the payer to stop processing all claims while the dispute is being resolved
- A patient chooses to pay out of pocket for elective services to avoid impacting their lifetime benefit limits for that service category
- A dependent on a family plan does not want the policyholder to see EOB statements for certain medical services
Commonly Paired With
No common pairings documented yet.