One of the many security benefits of the policy number migration to Medicare Beneficiary Identifiers (MBI) is the ability for Medicare to issue a new number anytime a beneficiary’s card is lost or compromised. Unfortunately, if a customer receives a new number but does not provide it to their suppliers, those suppliers will get:
No worries. Follow these steps to find the beneficiary’s new policy number:
Wait! What? Social Security Numbers are Required to Lookup MBIs?
Another of the many security benefits of the MBI is the elimination of the need to obtain and store Social Security numbers. Under the premise of identity protection, CMS issued over 44 million MBIs to eradicate Social Security number-based policy numbers … only to continue to require suppliers to collect and maintain SSNs for MBI lookup purposes? MiraVista is seeking guidance from the MACs on possible alternatives to Social Security numbers for identification queries. But for now, suppliers cannot query a new MBI without having the customer’s SSN.
[Need a quick way to be the boss’s go-to billing expert and problem solver? Try (K)notes.]
MBI-Related Rejections
Suppliers still submitting claims with the old policy numbers are likely suffering an influx of claim rejections. Regardless of service date, Medicare claims submitted with a legacy HICN reject with the following codes:
Denied and rejected claims require prompt intervention. Start by using the MAC web portals to obtain current MBIs:
If you have any questions, give us a shout.
SOURCE LINKS
https://cgsmedicare.com/jc/pubs/news/2019/11/cope14782.html
https://cgsmedicare.com/articles/cope14902.html
https://med.noridianmedicare.com/web/jddme/topics/ra/denial-resolution/ma27-n382-16
- “Invalid Member ID” when performing the eligibility check, or
- CO-16 denials with the MA27 and N382 remark codes.
No worries. Follow these steps to find the beneficiary’s new policy number:
- Backdate the eligibility query with an earlier search date (when the MBI was known to be valid). A valid response will provide a term date for the defunct MBI.
- Use the MBI Lookup Tool on the MAC Portal to obtain the active MBI. Enter the following beneficiary identifiers to return the active MBI:
- First name.
- Last name.
- Suffix (if applicable).
- Date of birth.
- Social Security number (SSN).
Wait! What? Social Security Numbers are Required to Lookup MBIs?
Another of the many security benefits of the MBI is the elimination of the need to obtain and store Social Security numbers. Under the premise of identity protection, CMS issued over 44 million MBIs to eradicate Social Security number-based policy numbers … only to continue to require suppliers to collect and maintain SSNs for MBI lookup purposes? MiraVista is seeking guidance from the MACs on possible alternatives to Social Security numbers for identification queries. But for now, suppliers cannot query a new MBI without having the customer’s SSN.
[Need a quick way to be the boss’s go-to billing expert and problem solver? Try (K)notes.]
MBI-Related Rejections
Suppliers still submitting claims with the old policy numbers are likely suffering an influx of claim rejections. Regardless of service date, Medicare claims submitted with a legacy HICN reject with the following codes:
- A7 (rejection for invalid information).
- 164 (entity’s contract/member number).
- IL (subscriber).
Denied and rejected claims require prompt intervention. Start by using the MAC web portals to obtain current MBIs:
- Jurisdictions A and D - https://www.noridianmedicareportal.com.
- Jurisdictions B and C - https://mycgsportal.com/MyCGS/CGSAccount/Login
If you have any questions, give us a shout.
SOURCE LINKS
https://cgsmedicare.com/jc/pubs/news/2019/11/cope14782.html
https://cgsmedicare.com/articles/cope14902.html
https://med.noridianmedicare.com/web/jddme/topics/ra/denial-resolution/ma27-n382-16
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