Medicare Claims Processing Manual (Pub. 100-04), Ch. 2 § 10.1.2
Contractor Procedures for Obtaining Missing or Incorrect
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.