New Medicare Card:

Claim Reject Codes After January 1

Starting January 1, 2020, you must use Medicare Beneficiary Identifiers (MBIs) when billing Medicare regardless of the date of service:

·         Medicare will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions

·         Medicare will reject all eligibility transactions submitted with HICNs

If you do not use MBIs on claims after January 1, you will get:

• 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)
• 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”

Do not wait. Protect your patients’ identities by using MBIs now for all Medicare transactions. Need an MBI?

• Ask your patients for their cards. If they did not get a new card, give them the Get Your New Medicare Card flyer in English or Spanish.
• Use your Medicare Administrative Contractor’s look-up tool. Sign up for the Portal to use the tool.
• Check the remittance advice. Medicare return the MBI on the remittance advice for every claim with a valid and active HICN.

For more information, see the MLN Matters Article.