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Home Health & Hospice Week

Industry Note:

Check Claims For Patient Name/HIC Number CWF Mismatch

Published on Thu Dec 06, 2012

If you’re seeing more returned claims due to a patient name or HIC number mismatch with the Common Working File, you’re not alone. Background: Starting Oct. 1, Medicare Administrative Contractors have been returning claims on which the beneficiary’s name or HIC number doesn’t match the CWF information. The transmittal from April detailing the change is online at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2449CP.pdf. "We have seen an increase in reason code N5052 (name/number does not match what is on file)," says HHH MAC NHIC in a message to providers. "In October 2012, reason code N5052 … was a top billing error for home health and hospice providers billing to CGS," that MAC adds in a post on its website. Do this: "It is very important for providers to be aware that when checking the beneficiary’s eligibility, the name may include apostrophes, commas, hyphens, JRs, and other similar suffixes," NHIC says. "If the beneficiary’s name [...]
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