CMS Pub. 100-04, ch. 30, § 150.9

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 a beneficiary requests an appeal of the initial denial, process the appeal in the

normal fashion except that, where the appeal results in a reversal, include the following

special paragraph in the appeal notice sent to the beneficiary:

The supplier which furnished this item or service has been informed of

this decision and advised that it may collect its full charge for the item or

service.

Send the supplier which furnished the item or service a separate notice which clearly

identifies the item or service for which payment is being made (i.e., include the patient’s

name, Medicare beneficiary identifier, a description of the item or service billed by

procedure code, date and place of service, and amount of the charge. Include the

following language:

You were previously advised that Medicare payment could not be made for this

item or service. However, after reviewing this claim, we have determined that

payment may be made. Therefore, if you have already refunded the amounts you

collected from the beneficiary for this item or service, you may recollect these

amounts.