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.
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:
Paper claims that fail to use the MBI can anticipate the following rejection notices:
Every healthcare provider, physician, and supplier that submits claims to the Medicare Administrative Contractors (MACs) for services rendered to Medicare beneficiaries must use MBIs.
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.
MBIs are required, with three exceptions:
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
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.
Ready to get started? Complete the contact request form on this page or call us at 800-474-4489.
1 These methods may not return accurate information in a timely manner and can affect reimbursement.