Ophthalmology and Optometry Coding Alert

Question: Our Part B MAC has now rejected three claims for invalid member identification numbers, even though I know I have their Medicare Beneficiary Identifiers (MBIs) correct. What could the problem be? 

Alabama Subscriber

Answer: If you’re getting rejections due to incorrect MBIs, do some research into the error code.

“If you get an eligibility transaction error code (AAA 72) of ‘invalid member ID,’ or ‘The beneficiary you requested cannot be found. Please verify your information,’ your patient’s MBI may have changed” since it was originally issued, CMS explains in a new article. “Remember, requests to change MBIs can occur if a Medicare beneficiary, their authorized representative, or CMS suspects a number is compromised.”

Patients may give you the old card or seek care before receiving a new one.

Tip: When you get such an error code, “do a historic eligibility search to get the termination date of the old MBI,” CMS advises. Then, “get the new MBI from your Medicare Administrative Contractor’s secure lookup tool.”