Transition to Medicare Beneficiary Identifier (MBI) for claims submission
December 23, 2019 – According the Centers for Medicare and Medicaid Services (CMS) Weekly Digest Bulletin, Medicare providers are required to submit claims for beneficiaries using Medicare Beneficiary Identifier (MBI) cards starting January 1, 2020. The MBI cards will identify beneficiaries without the use of social security numbers (SSNs), which offers better identity protection. This change in identification is a result of a mandate set forth by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) for CMS to remove social security numbers from all Medicare cards by April 2019. CMS replaced the SSN based Health Insurance Claim Numbers (HICNs) with randomly generated MBI numbers. With a few exceptions, both electronic and paper claims without MBI numbers will receive:
- Electronic claims reject codes – Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber); or
- Paper claims notices – Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”.
For more information on how to receive and use MBI for payment of Medicare claims .
