Skip to main content

N617 Remark Code: Second or Third Month of Grace Period

N617 means the enrollee is in the second or third month of the advance premium tax credit grace period. The plan may pend claims for these months; they are paid if the enrollee catches up on premiums and may be denied if coverage is terminated.

Quick facts

Code
N617 (RARC N617)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): The claim is pended; the amount is undetermined until the grace period resolves.
  • CO (Contractual Obligation): Some issuers report the hold under CO. It is not a final denial while the grace period is open.
Official description
This enrollee is in the second or third month of the advance premium tax credit grace period.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N617 means

Marketplace enrollees who receive advance premium tax credits get three months to catch up on unpaid premiums. The plan must pay first-month claims, but for services in months two and three, it can hold claims until it knows whether the enrollee will pay. N617 tells you this service falls in those later months.

Unlike N615 and N616, N617 is not labeled as an alert. It explains why the claim has not been paid. It commonly appears with CARC 257.

What happens next

  • If the patient pays all past-due premiums by the end of the grace period, the plan should process the pended claims normally.
  • If the patient doesn’t pay, coverage is typically terminated effective the last day of the first grace month, and claims for months two and three are denied, often with CARC 27 (expenses after coverage terminated).

What to do

  1. Record the pended status and the expected end of the grace period.
  2. Contact the patient. Explain that their claim is on hold and their coverage depends on paying the premium.
  3. Verify eligibility before new services and discuss self-pay arrangements if coverage may end.
  4. Follow up after the grace period ends. If the claim is denied for termination, bill the patient or other coverage according to your policy.

How to prevent surprises

Check eligibility at every visit for Marketplace patients, since grace-period status can change monthly. Real-time eligibility responses often show when a member is in a grace period. See eligibility and COB denials.

Codes that may appear with N617

  • OA-257 (The disposition of the claim/service is undetermined during the premium payment grace period, per Health Insurance Exchange requirements.): The claim disposition is undetermined during the Exchange premium grace period.
  • PR-27 (Expenses incurred after coverage terminated.): Used if the claim is later denied because coverage terminated.
  • N615 (Alert: This enrollee receiving advance payments of the premium tax credit is in the grace period of three consecutive months for non-payment of…): The general alert that the enrollee is in the grace period.
  • N616 (Alert: This enrollee is in the first month of the advance premium tax credit grace period.): The first month, when appropriate claims are paid.
  • N618 (Alert: This claim will automatically be reprocessed if the enrollee pays their premiums.): The claim will be reprocessed automatically if premiums are paid.
  • N619 (Coverage terminated for non-payment of premium.): Coverage terminated for non-payment of premium.

N617 FAQ

Will the claim be paid eventually?

Only if the enrollee pays all outstanding premiums before the grace period ends. Otherwise coverage terminates and the claim is usually denied.

Should I resubmit?

No. The claim is pended. The plan will reprocess or deny it when the grace period resolves.

Can I bill the patient now?

That depends on your financial policy and state rules. Many practices inform the patient and wait for the final outcome before billing.