Last Modified: 4/18/2020
Location: FL, PR, USVI
Business: Part A
Q: We are receiving reject reason code U5061. What steps can we take to avoid this reason code?
for a description associated with the Medicare Part A reason code(s). Simply enter a valid reason code into the box and click the submit button.
: Effective April 1, 2018, you will receive this reason code when a submitted Health Insurance Claim (HIC) number is not found in the Common Working File
Remember to check with the beneficiary and/or representative for eligibility prior to submitting claims to Medicare.
for resources to verify the patient’s eligibility.
To avoid this reject code in the future a few things you can do when a beneficiary comes to your facility:
• Request a copy of the Medicare card prior to providing services.
• Verify the eligibility dates on the card are valid for the date of service(s).
• Validate the name on the Medicare claim matches the name as it appears on the Medicare card. Do not use nicknames.
• If everything matches on the Medicare card, the beneficiary should verify eligibility with the Social Security Administration (SSA).
Source: Provider Outreach and Education
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