Conducting the Telephone Reopening

10.5.3 - Conducting the Telephone Reopening (Rev. 4219, Issued: 01-25-19, Effective: 02-26-19, Implementation: 02-26-19) 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. Prior to conducting a telephone reopening, the caller must provide the following three items: • Verify the provider’s/physician’s/supplier’s name and identification number or National Supplier Clearinghouse number; • Beneficiary last name, first initial; and • Medicare number. Items must match exactly. The contractor should also inform the caller that the call may be monitored for quality assurance. The following items shall be obtained/recorded/confirmed during telephone reopening: • Date of call; • Name of caller; • Phone number of the party; • Name of provider/physician/supplier of item or service; • Dates of service; • Which items(s) or service(s) are at issue; • Reason for the request; • Any new information that is received during the telephone call; • Rationale for not processing the request, if applicable; • Any appeal rights, if applicable; • Name of the reviewer; • Confirmation number, if applicable; and • Inform the caller that the call may be monitored.