• 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:

• We will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions

• We 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”

Understanding the Medicare Beneficiary Identifier (MBI) Format

The MBI has 11 characters, like the Health Insurance Claim Number (HICN), which can have up to 11.

Each MBI is randomly generated. This makes MBIs different than HICNs, which are based on the Social Security Numbers (SSNs) of people with Medicare. The MBI’s characters are “non-intelligent” so they don’t have any hidden or special meaning.

Each person with Medicare will get their own randomly-generated MBI. Spouses or dependents who may have had similar HICNs will each get their own different MBI.

MBIs are numbers and upper-case letters. We’ll use numbers 0-9 and all letters from A to Z, except for S, L, O, I, B, and Z. This will help the characters be easier to read.

The MBI will contain letters and numbers. Here’s an example: 1EG4-TE5-MK73

• The MBI’s 2nd, 5th, 8th, and 9th characters will always be a letter.
• Characters 1, 4, 7, 10, and 11 will always be a number.
• The 3rd and 6th characters will be a letter or a number.
• The dashes aren’t used as part of the MBI. They won’t be entered into computer systems or used in file formats.

                                                                        C – Numeric 1 thru 9

                                                                        N – Numeric 0 thru 9

                                                                       AN – Either A or N

                                                                        A – Alphabetic Character (A…Z); Excluding (S, L, O, I, B, Z)

Position 1 – numeric values 1 thru 9
Position 2 – alphabetic values A thru Z (minus S, L, O, I, B, Z)
Position 3 – alpha-numeric values 0 thru 9 and A thru Z (minus S, L, O, I, B, Z)
Position 4 – numeric values 0 thru 9
Position 5 – alphabetic values A thru Z (minus S, L, O, I, B, Z)
Position 6 – alpha-numeric values 0 thru 9 and A thru Z (minus S, L, O, I, B, Z)
Position 7 – numeric values 0 thru 9
Position 8 – alphabetic values A thru Z (minus S, L, O, I, B, Z)
Position 9 – alphabetic values A thru Z (minus S, L, O, I, B, Z)
Position 10 – numeric values 0 thru 9
Position 11 – numeric values 0 thru 9

MBIs will fit on forms the same way HICNs do. You don’t need spaces for dashes.