Disposition Code 52 (Beneficiary Record at another Host)

20.3.3.3 - Disposition Code 52 (Beneficiary Record at another Host) (Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18) • When CMS receives a request for transfer, it searches its Master File to determine if the Beneficiary Record resides at another Host. • The CMS first searches the record based on the HICN. If a match is found, and the beneficiary has not already been assigned to a Host, CMS sends the records to the requesting Host. After the Host receives the record, it can process the claim from the MAC on its next cycle. • If a match is found that indicates the beneficiary has been assigned to another Host, CMS sends the requesting Host a code 52. The requesting Host then sends the claim information to the receiving Host that has the Beneficiary Record. • The requesting Host will give the processing MAC a code 52 and Trailer 08 with a 5052 error code. • The MAC holds the claim and resends (recycles) it in five working days to see if there is a response waiting. • If the response is present on the first recycle of the claim, the MAC finishes processing the claim according to the response. • If a response is not present, the MAC receives another disposition code 52 and the claim is sent to the proper Host for processing. • The MAC recycles the claim after another five working days, and continues recycling the claim until it receives an approval, adjustment, or reject (AAR) response, or until 45 working days have passed. • After 45 working days have passed with no AAR response, the MAC reports the problem to the Host through locally established reporting procedures.