CMS Pub. 100-04, ch. 2, § 10.9

Patient’s Medicare beneficiary identifier

(Rev. 4247, Issued: 03-01-19, Effective: 04-01-19, Implementation: 04-01 -19)

The term Medicare beneficiary identifier (Mbi) is a general term describing a

beneficiary's Medicare identification number. For purposes of this manual, Medicare

beneficiary identifier references both the Health Insurance Claim Number (HICN) and

the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition

period and after for certain business areas that will continue to use the HICN as part of

their processes.

Where the name and Medicare beneficiary identifier information on a claim does not

match the CMS central record, the A/B MAC (A), (B), or (HHH), or DME MAC will

return the claim to the provider and request the provider to verify the information.

The provider will compare the name and number on the claim with that on provider

records. If the information submitted was incorrect, the provider will return the claim to

the MAC with the corrected information.

If, however, the information in the provider’s records identifying the patient is the same

as the information submitted on the claim, the provider will contact the SSO for

assistance.