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ZOLL® AR Boost®

MBI Lookup Tool

The ZOLL® AR Boost® MBI lookup and converter tool makes it easy to find a patient’s MBI.

 What Is a Medicare Beneficiary Identifier (MBI)?

As of January 1, 2020, the Centers for Medicare and Medicaid Services (CMS) requires Medicare Beneficiary Identifiers (MBIs) to be used for all Medicare transactions such as billing, claim submissions, and appeals. The 11-character patient identification numbers replace the social security number-based health insurance claim numbers (HICNs) previously used for Medicare patients.

Example Medicare Health Insurance Card

Who Is Affected?

Every healthcare provider, physician, and supplier that submits claims to the Medicare Administrative Contractors (MACs) for services rendered to Medicare beneficiaries must use MBIs.

Healthcare worker explaining form to older male patient

 Medicare will reject claims and transactions that fail to use MBIs. If you are not using MBIs on current claims, you will get the following electronic claims rejection codes:

  • A Claims Status Category Code of A7 (acknowledgment rejected for invalid information)
  • A Claims Status Code of 164 (entity’s contract/member number)
  • An Entity Code of IL (subscriber)

Paper claims that fail to use the MBI can anticipate the following rejection notices: 

  • Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)”
  • Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

What are the benefits of RescueNet ePCR Work?

  • Optimized for touch-screen tablets
  • Spell-check with a medical dictionary to help ensure professional reports
  • Easily tab from field-to-field when using keyboard-based input
  • Create editable, automated narratives
  • Logical flow to allow you to collect data in the same process that you provide care
  • Collect signatures electronically
  • QuickLog allows fast time-stamping of common procedures.
  • Complete, validated data maximizes billing reimbursement
  • Rules to let medics know what data is missing to complete the report.
  • Provide hospitals with completed run reports
Man in suit holding phone in hand with technology icons floating above it

Are There Exceptions to the MBI Requirement?

MBIs are required, with three exceptions:

  • Medicare appeals: When you file an appeal, you can choose whether to use an MBI or an HICN.
  • Checking the status of a claim: If you filed a claim before January 1, 2020, you can use an HICN to check the status of a claim. If you filed it after that date, you’ll have to use the MBI.
  • Span-date claims: Some providers submit single claims for services that span multiple days. These might include instances of inpatient treatment or home health. If the services rendered concluded before December 31, 2019, you may submit a claim using the HICN or the MBI.

How Is the MBI Formatted?

The MBI number is a string of 11 randomly generated numbers and upper-case letters, excluding B, I, L, O, S, and Z to prevent confusion with similar-looking numbers. There are no hyphens or spaces in these sequences. If you include hyphens in your claim, it could be rejected. MBIs are sometimes shown with hyphens — for example, on a Medicare card — strictly for ease of reading. You can visit cms.gov for more information on the format of an MBI.

Save Time and Frustration With Automated MBI Lookup

Processing Medicare claims can be frustrating and labor-intensive. With the MBI lookup tool, it's easy to get clean claims out the door quickly and efficiently. If you’re a RescueNet® Billing Pro, ZOLL Billing, or ZOLL AR Boost® customer, the MBI lookup tool is already built into your solution. If you’re not a ZOLL Data Systems customer, the MBI lookup, Medicare eligibility, and Insurance Discovery tools can be integrated quickly and easily into any billing system. 

 How Can Providers Quickly Obtain MBI Numbers?

ZOLL Data Systems has built an MBI lookup tool and converter into our billing solutions to make it easy to find a patient’s MBI. Any provider or billing software vendor can automatically identify and convert a HICN or SSN to MBI. The MBI lookup tool accelerates what is otherwise a time-consuming, manual process. Automatic lookup facilitates clean claims and optimum reimbursement.

ZOLL Data Systems can also execute batch queries for all Medicare patients in your databases. Simply send a batch file containing each patient record, in Excel format, through our secure portal. We will run our proprietary, enhanced MBI lookup process and deliver updated MBI numbers for all valid HICN and/or SSN within 24 hours.

If you are not a ZOLL Data Systems billing solution user, you can obtain the MBI number using one of three manual methods: 

  1. 1. 835 remittance files: An Electronic Remittance Advice (ERA), also known as an 835, is an electronic transaction that provides information about claim payments. Many practices and billing companies utilize these so that claim payments post to their systems automatically.
  2. 2. MBI lookup on the MAC website: You can visit a MAC website to look up the MBI you need or go to cms.gov to find your MAC’s website by name or state.
  3. 3. Medicaid may return the MBI on an eligibility response

 

MBI Discovery Form

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