New Medicare Card: Claim Reject Codes After January 1

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Submitted by J3SJ on Wed, 11/27/2019 - 15:55
Date
2019-11-26
Subject
New Medicare Card: Claim Reject Codes After January 1
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 SPECIAL EDITION

Tuesday, November 26, 2019

 

New Medicare Card: Claim Reject Codes After January 1

Get paid. Use Medicare Beneficiary Identifiers (MBIs) now.

If you do not use MBIs on claims (with a few exceptions) 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”

We encourage people with Medicare to carry their cards with them since we removed the Social Security Number-based number; if your patients do not bring their Medicare cards with them:

  • Give them the Get Your New Medicare Card flyer in English (PDF) or Spanish (PDF).
  • Use your Medicare Administrative Contractor’s look-up tool. Sign up (PDF) for the Portal to use the tool.
  • Check the remittance advice. Until December 2019, we return the MBI on the remittance advice for every claim with a valid and active Health Insurance Claim Number (HICN).

See the MLN Matters Article (PDF) to learn how to get and use MBIs.

View this edition as a PDF (PDF)

 

 


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