CO-140 — Patient/Insured ID and Name Mismatch (Registration)
The insurance ID number and the patient/subscriber name submitted on the claim do not match what the payer has on file, so the payer's system cannot locate the correct member record to adjudicate the claim.
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In plain language
The insurance ID number and the patient/subscriber name submitted on the claim do not match what the payer has on file, so the payer's system cannot locate the correct member record to adjudicate the claim.
Start here
Re-verify eligibility directly with the payer (portal, 270/271 transaction, or phone) using the patient's date of birth and any available ID fragment.
Who resolves it
Billing/Claims follow-up
Who prevents it
Patient Access/Registration — accurate capture of legal name and insurance ID at check-in, including verification against a scanned or swiped insurance card rather than manual entry alone.
Sources
- X12 CARC list; X12 RARC list
Validated ClaimetryX Source — Denial Management Knowledge Base, 2026 Research Edition
Research date August 18, 2026. CARC/RARC combinations and payer processes vary. Always check the specific remittance advice and the payer's current requirements before acting on any denial.
Published by ClaimetryX. Sources identify the code standards, agency guidance, and payer policies supporting this reference. How we use sources
How to resolve this denial, step by step
- 1
Re-verify eligibility directly with the payer (portal, 270/271 transaction, or phone) using the patient's date of birth and any available ID fragment.
- 2
Compare the payer's returned name/ID exactly against what was submitted on the claim.
- 3
Correct the demographic and/or ID fields in the practice-management system.
- 4
Resubmit as a corrected claim (not a new original claim) to avoid triggering a duplicate- claim edit.
- 5
Update the patient's stored record so the corrected information carries forward to future encounters.
Then choose the correct disposition
Corrected claim
appropriate once the accurate name/ID combination is confirmed with the payer; this is a data-matching issue, not a benefit or medical-necessity determination, so no formal appeal is typically needed.
Appeal
rarely applicable; reserved for the unusual case where the payer's own eligibility file is wrong and the payer requires a formal dispute process to correct it.
Stop and escalate when
- The payer's eligibility response does not match any name/ID combination the patient or registration has on file; repeated CO-140 denials for the same patient across multiple visits, suggesting a systemic registration data-entry issue.
What Needs to Be Corrected
- A. Claim-data correction: Correct the patient/subscriber name and/or ID number on the claim to exactly match the payer's eligibility record, then resubmit as a corrected claim.
- B. Upstream operational correction: If the registration system consistently stores an incorrect name format (e.g., nickname instead of legal name) for this patient, correct the patient's demographic record at the source so future claims do not repeat the error.
Do Not Do This
- Do not guess at a corrected ID number without confirming it against a payer eligibility response or the insurance card; an incorrect guess can trigger repeat denials or misdirect the claim to the wrong member's record.
- Do not resubmit as a brand-new original claim without referencing/replacing the original (this can trigger a duplicate-claim CARC 18 denial in addition to the original issue).
Plain-Language Meaning
- The insurance ID number and the patient/subscriber name submitted on the claim do not match what the payer has on file, so the payer's system cannot locate the correct member record to adjudicate the claim.
Why Denied
- Registration/Eligibility: insurance card was misread, mistyped, or outdated at time of registration
- Registration/Eligibility: name entered does not match the payer's legal-name record (e.g., maiden name, suffix, hyphenation, nickname)
- Registration/Eligibility: subscriber ID entered instead of dependent ID, or vice versa, on a family policy
- Coding/Claim construction: transposed digits or truncated ID number during data entry
Information Biller Must Review
- Current insurance card (front and back) or verified eligibility response, patient's legal name as filed with the payer, subscriber vs. dependent relationship and correct ID suffix, prior claims history for the same patient/payer showing a previously accepted ID.
Sample Scenario
- Scenario: Claim denied CO-140/MA27 for a patient billed under a shortened first name.
- Finding: Payer's eligibility file lists the patient's full legal first name, which differs from what was entered at registration.
- Action: Corrected claim submitted with the legal name matching the payer record; patient's stored demographic record updated to prevent recurrence.
Denial Identifier
- Primary CARC (Group Code CO): CO-140 — "Patient/Insured health identification number and name do not match." (X12)
- Common accompanying RARC: MA27 — "Missing/incomplete/invalid entitlement number or name shown on the claim" (X12)
- Other related RARC: N435 — "Exceeds number/frequency approved/allowed within time period without support documentation" is not applicable here; more relevant is MA61 — "Missing/incomplete/invalid social security number" in payers still using SSN-based legacy identifiers. RARC pairing varies by payer eligibility system; do not assume MA27 always accompanies CO-140.
Prevention Control
- Real-time eligibility verification (270/271) at scheduling and check-in; card-scan or swipe capture instead of manual key-entry where available; a standardized process for capturing legal name exactly as it appears on the insurance card.
Department Most Likely Responsible
- Resolves current claim: Billing/Claims follow-up. Prevents recurrence: Patient Access/Registration — accurate capture of legal name and insurance ID at check-in, including verification against a scanned or swiped insurance card rather than manual entry alone.
AI Answer Guardrail
- Verify the correct name/ID combination directly against a current payer eligibility response before recommending a claim correction; do not recommend a guessed correction.
AI Search Terms / Synonyms
- CO140; MA27; name mismatch; ID mismatch; subscriber ID error; registration error; eligibility mismatch.
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