Reason Code N5052

Published 12/16/2019

The beneficiary's Medicare ID number, name, sex, or date of birth submitted on the claim does not match the Medicare ID number, name, sex or date of birth in the Common Working File (CWF) eligibility records.

Before submitting your claim, verify that the beneficiary's personal characteristics (name, sex or date of birth) and Medicare ID number on your claim matches CWF. In addition to the correct spelling of the name, if CWF includes a space in the last name, you must also include a space when submitting your claim, or vice versa (e.g., McDonald vs. Mc Donald). Likewise, do not include a comma or a period unless the name appears as such on CWF. Other resources that are available to verify the beneficiary's name, sex, date of birth and Medicare ID number include:

  • eServices Portal
  • Interactive Voice Response (IVR)
  • Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS). For information about HETS, refer to the HETS User Guide (PDF) 


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