Denial Code 140 means that the patient/insured health identification number and name do not match. This can result in a claim being denied by the insurance company. In this article, we will provide a description of denial code 140, common reasons for its occurrence, next steps to resolve the issue, tips on how to avoid it in the future, and examples of denial code 140 cases.
2. Description
Denial Code 140 is a claim adjustment reason code that indicates a mismatch between the patient/insured health identification number and name. This means that the information provided on the claim does not match the records held by the insurance company. As a result, the claim is denied, and the provider will not receive payment for the services rendered.
2. Common Reasons
The most common reasons for denial code 140 are:
- Incorrect Patient Information: One of the main reasons for denial code 140 is when the patient’s health identification number or name is entered incorrectly on the claim. This could be a typographical error or a misunderstanding of the patient’s information.
- Outdated or Inaccurate Insurance Records: If the insurance company has outdated or inaccurate records for the patient, it can lead to a mismatch between the health identification number and name. This can occur when the patient has changed insurance providers or if there are errors in the insurance company’s database.
- Data Entry Errors: Mistakes made during the data entry process can also result in denial code 140. This could be due to human error or system glitches that cause the patient’s information to be recorded incorrectly.
3. Next Steps
If you receive denial code 140, here are the next steps to resolve the issue:
- Verify Patient Information: Double-check the patient’s health identification number and name against their insurance card or other official documents. Ensure that the information entered on the claim matches the patient’s records.
- Contact the Insurance Company: Reach out to the insurance company’s provider support to inform them of the denial code 140 and request clarification on the mismatch. Provide them with the correct patient information and ask for guidance on how to proceed.
- Submit Corrected Claim: If the insurance company confirms that there was an error in their records, submit a corrected claim with the accurate patient information. Include any documentation or proof of the correct information to support your claim.
- Follow Up: Keep track of your communication with the insurance company and follow up regularly to ensure that the issue is resolved. Document all conversations and any instructions or guidance provided by the insurance company.
4. How To Avoid It
To avoid denial code 140 in the future, consider the following tips:
- Double-Check Patient Information: Take extra care when entering the patient’s health identification number and name on the claim. Verify the information with the patient and their insurance card to ensure accuracy.
- Update Insurance Records: Regularly update your records with the most current information provided by the insurance company. This includes any changes in the patient’s health identification number or name.
- Implement Quality Control Measures: Establish quality control measures within your billing and administrative processes to catch any data entry errors before claims are submitted. This can include double-checking information and implementing validation checks.
- Train Staff: Provide training to your staff on the importance of accurate patient information and the potential consequences of mismatched health identification numbers and names. Emphasize the need for attention to detail and thoroughness in data entry.
5. Example Cases
Here are two examples of denial code 140:
- Example 1: A healthcare provider submits a claim for a patient using an outdated health identification number. The insurance company denies the claim under denial code 140 due to the mismatch between the health identification number and the patient’s current information.
- Example 2: A data entry error results in the patient’s name being misspelled on the claim. The insurance company rejects the claim under denial code 140 as the name does not match the health identification number on record.
