CO-140 — Patient/Insured ID and Name Mismatch (Registration)

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.

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• Registration/Eligibility: insurance card was misread, mistyped, or outdated at time of registration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.

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.

Resolution Workflow

• 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.
• Compare the payer's returned name/ID exactly against what was submitted on the claim.
• Correct the demographic and/or ID fields in the practice-management system.
• Resubmit as a corrected claim (not a new original claim) to avoid triggering a duplicate- claim edit.
• Update the patient's stored record so the corrected information carries forward to future encounters.

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.

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.

Escalation Trigger

• 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.

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.

Resolution path at a glance

AI Search Terms / Synonyms

• CO140; MA27; name mismatch; ID mismatch; subscriber ID error; registration error; eligibility mismatch.

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.

Sources

• X12 CARC list; X12 RARC list