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N897 Remark Code: Proof of Member Payment Needed

N897 means proof of member payment was missing, incomplete, or invalid. The payer needs evidence, such as an itemized paid receipt, that the member actually paid for the service before it will process the claim, often a claim seeking reimbursement for the member.

Quick facts

Code
N897 (RARC N897)
Status
Active In use since July 1, 2024.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Amounts held because the payment proof was not acceptable. When a provider submitted the claim, supplying proof is the provider's task.
  • PR (Patient Responsibility): On member-submitted reimbursement claims, the amount stays with the member until acceptable proof of payment is provided.
Official description
Missing/incomplete/invalid proof of member payment.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N897 means

Most claims ask the payer to pay the provider. Some ask the payer to reimburse the member, who has already paid out of pocket. In that case the payer wants to see that the payment really happened. N897 means the evidence it received did not hold up, or there was none.

The remark covers three different problems: no proof at all, proof that leaves out key details, or a document the payer cannot accept.

Common causes

  • The member sent a bill or estimate instead of a paid receipt.
  • The receipt lacks the date of service, services, or amount paid.
  • The amount paid on the receipt does not match the claim.
  • The payer’s own form or statement was required and not completed.

How to fix it

  1. Identify who filed the claim and what the payer asked for.
  2. Provide an itemized paid receipt or patient ledger showing dates, services, charges, and payments.
  3. Match it to the claim so the amounts and dates agree.
  4. Resubmit following the payer’s instructions for reimbursement claims or attachments.

How to prevent it

When patients pay at the time of service, give them an itemized, paid receipt with your NPI and tax ID so they can file for reimbursement on the first try.

Codes that may appear with N897

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Information needed for adjudication is missing; N897 names payment proof.
  • 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 insufficient.
  • N26 (Missing itemized bill/statement.): An itemized bill or statement is missing, which is not the same as proof that it was paid.
  • N179 (Additional information has been requested from the member.): Additional information was requested from the member.
  • CO-100 (Payment made to patient/insured/responsible party.): Payment was made to the patient or insured rather than to the provider.

N897 FAQ

What counts as proof of payment?

Usually a receipt or statement from the provider showing the date of service, the services, the amount charged, the amount paid, and how it was paid. A plain invoice without a paid amount is often not enough.

Why would a payer need proof the member paid?

When the plan reimburses the member directly, for example for out-of-network care or services paid at the time of the visit, it wants evidence it is not reimbursing an unpaid bill.

Can the provider send the proof?

Often yes. A provider can supply a paid-in-full receipt or ledger when the member asks, or when the provider filed the claim on the member's behalf.