Avoid Rejected Claims in the New Year! Important Reminders about MBIs

Effective January 1, 2020, all claims submitted to Medicare must be billed with the new Medicare Beneficiary Identifier (MBI) in place of the Health Insurance Claim number (HICN). The new year is almost here, and the Novitas EDI Department wants to make sure you are ready!

As of January 1, 2020, any claim files submitted without the MBI, or with an incorrect MBI will reject on the 277CA claims acknowledgement report with a A7:164:IL (Invalid Information within the Subscriber’s contract/member number) before entering the claim processing system.

What steps should you take NOW?

  • Obtain the patient’s MBI. Ask your Medicare patients for their new Medicare card, use the MBI Lookup tool in Novitasphere, or check your remittance advice. The MBI will be returned on the remittance advice for every claim with a valid and active HICN until December 31, 2019.
  • Update your systems with the MBI and begin using it to submit claims now. Steps to update your systems are available here:
  • Ensure your billing service or clearinghouse has updated their records, and is submitting the MBI on your behalf. Customers who utilize a third party biller may notice that a partial HICN and the MBI are appearing on the remittance advice. This means that although you may have provided the MBI to your billing service/clearinghouse, they are not using the MBI when submitting your claims.

Important Reminders

  • Use the MBI Lookup tool here in Novitasphere to obtain your patients’ MBIs!
  • Remember, the MBI uses numbers 0-9 and all uppercase letters EXCEPT for S, L O, I, B, and Z. This is to avoid confusion when differentiating between certain letters vs numbers like the number zero and the letter O.
  • Review this MLN Matters Article for additional information on using MBIs.

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