Look up another code

N375 Remark Code: Dependent Eligibility Questionnaire

N375 means the questionnaire or information the payer needs to confirm the patient's eligibility as a dependent was missing, incomplete, or invalid, so the claim could not be paid.

Code: N375 (RARC N375)
Status: Active In use since December 1, 2006.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: PR (Patient Responsibility): When the subscriber or patient must return the questionnaire, some payers assign the amount to the patient until eligibility is confirmed.
CO (Contractual Obligation): Other payers hold the amount as a provider adjustment while dependent status is verified. Either way, the claim can be reconsidered once the information arrives.
Official description: Missing/incomplete/invalid questionnaire/information required to determine dependent eligibility.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N375 means

Plans need to confirm that dependents still qualify for coverage. That can mean checking an adult child’s age or student status, a disabled dependent’s condition, or a spouse’s relationship to the subscriber. When the plan sends a questionnaire and doesn’t get a complete answer, claims for that dependent stop paying. N375 tells you that is why this claim was denied.

It often pairs with CARC 32 (not an eligible dependent) or CARC 227 (information from the patient not provided).

Common causes

The subscriber never returned the plan’s dependent verification letter.
The form was returned but incomplete, unsigned, or missing documents such as a school enrollment letter.
The dependent aged out, or their status changed, and the subscriber hasn’t told the plan.
The plan’s letter went to an old address.

What to do

Tell the family. Contact the subscriber and explain that the plan needs the dependent eligibility information before it will pay.
Point them to the plan. They can usually complete it by phone, portal, or mail, and should ask what documents are needed.
Track the follow-up date. Check eligibility again after the subscriber says it’s done.
Reprocess the claim. Once eligibility is restored, ask the payer to reprocess or resubmit as it instructs.
Bill appropriately if the plan confirms the patient isn’t an eligible dependent: look for other coverage or bill the responsible party.

How to prevent it

Watch for dependents near age cut-offs or with student-status coverage, and check eligibility before each visit. When eligibility responses show a pending verification, let the family know before the appointment.

Codes that may appear with N375

CO-32 (Our records indicate the patient is not an eligible dependent.): The payer's records indicate the patient is not an eligible dependent.
CO-227 (Information requested from the patient/insured/responsible party was not provided or was insufficient/incomplete.): Information requested from the patient or insured was not provided or was incomplete.
CO-16 (Claim/service lacks information or has submission/billing error(s).): Claim information is missing, here the dependent eligibility details.

N686 (Missing/incomplete/Invalid questionnaire needed to complete payment determination.): Used when a questionnaire is needed to complete a payment determination more generally.
N179 (Additional information has been requested from the member.): Says additional information was requested from the member and the charges will be reconsidered.
N366 (Requested information not provided.): Says requested information was not provided but the claim will be reopened if it is submitted within one year.

N375 FAQ

Who fills out the dependent questionnaire?

Usually the subscriber, meaning the parent or spouse who holds the policy. The provider generally can't complete it for them.

What does the payer want to know?

It varies by plan. Common questions cover the dependent's age, student status, disability, or relationship to the subscriber.

How do I get the claim paid after the form is returned?

Ask the payer whether it will reprocess automatically once eligibility is updated or whether you need to resubmit or request reconsideration.

Important: read before using this information

This page is general educational information about a standard industry code set. It is not medical billing, coding, legal, reimbursement, or compliance advice, and it does not create a professional or advisory relationship with ClaimsRevenue.

Code definitions, payer usage, contracts, and laws change, and payers may apply the same code differently. The information is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, or currency. You are solely responsible for verifying it against the current official X12 code lists, CMS guidance, your payer contracts, and payer policies before relying on it, and for every billing, coding, collection, and appeal decision you make.

Using this information does not guarantee that any claim will be paid or that any appeal will succeed. To the fullest extent permitted by law, ClaimsRevenue and MOODRX LLC are not liable for any loss or damage arising from its use. Official code descriptions are published by X12 and are quoted for reference only. See our full Claims Validation Disclaimer.