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Last Modified: 11/4/2011
Location: FL, PR, USVI
Business: Part A
Avoiding RTP reason code N5052 FAQ
Q: We are receiving return to provider (RTP) reason code N5052, which indicates the beneficiary identification is incorrect. What steps can we take to avoid this reason code?
A: Always remember to check beneficiary eligibility prior to submitting claims to Medicare.
There are several ways to obtain beneficiary eligibility:
1. Direct data entry (DDE) 
users can access the eligibility information by using the ELGA (Eligibility Part A) screen.
users can access the eligibility information by using the ELGA (Eligibility Part A) screen.2. Contact the interactive voice response (IVR) system by calling (877) 602-8816.
system by calling (877) 602-8816.There are also a few things you can do when a beneficiary comes to your facility:
1. Always obtain copy of the red, white, and blue Medicare card prior to providing services.
2. Make sure the name of the claim matches the name as it appears in the Medicare red, white, and blue card. Do not use nicknames.
If the name on the card does not match the name submitted on the claim, make appropriate corrections and resubmit the claim.
Definition
RTP reason code N5052:
Beneficiary identification incorrect - the beneficiary name and or other personal data in the Common Working File (CWF) transaction did not match the data stored on the beneficiary master record.
Source: CMS Internet-only Manual (IOM) Pub. 100-04, Chapter 25 Completing and processing the form CMS-1450 data set 
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