Medicare Claims Processing Manual (Pub. 100-04), Ch. 2 § 10.1.2

Contractor Procedures for Obtaining Missing or Incorrect

Last amended: 2019Year: 2019Length: 141 wordsOfficial source
10.1.2 - Contractor Procedures for Obtaining Missing or Incorrect Medicare beneficiary identifiers (Rev. 4247, Issued: 03-01-19, Effective: 04-01-19, Implementation: 04-01 -19) The term Medicare beneficiary identifier (Mbi) is a general term describing a beneficiary's Medicare identification number. For purposes of this manual, Medicare beneficiary identifier references both the Health Insurance Claim Number (HICN) and the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition period and after for certain business areas that will continue to use the HICN as part of their processes. Upon receipt of a claim or other paper on which the Medicare beneficiary identifier is omitted, incomplete, inconsistent, or obviously incorrect, the MAC submits the claim to CWF with the best information it has available. Depending on the CWF reply, the MAC follows the instructions in Chapter 27 for handling various disposition codes, trailers, and error codes.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 2 § 10.1.2: Contractor Procedures for Obtaining Missing or Incorrect | Justis AI