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Monday, June 7, 2010

insurance denial - Patient/insured health identification number and name do not match


Denial Messages:

CO 140: Patient/insured health identification number and name do not match.

CO 13: The date of death precedes the date of service.

Services were denied for one or more of the following reasons:

  • Patient cannot be identified as our insured. The name or Medicare number was incorrect or missing. Please check the patient’s Medicare card.

  • The date of death precedes the date of service.

  • Expenses were incurred prior to coverage.

  • Expenses were incurred after coverage terminated.

  • Expenses were incurred prior to coverage. The service was not covered by Medicare at the time the patient received it.
Suggestions to reduce or eliminate these kinds of claim denials:

  • Patient screening is vital to an office’s success in capturing the necessary information for correct claim submission.

  • Office staff should obtain additional patient information when registering patients. Usually this is accomplished by the patient completing a medical information/history and insurance information form.
Pay close attention to:

o Obtaining the patient’s full name directly from the card.
o Patient address and phone number.
o Obtaining the name and identification number of other insurance (Medicare or other type of insurance plan involved).
o Date of birth.

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