RFI Browser

Back  RFI # 2232: Medicare MBI in 834

Formal vs. Informal Help Informal Formal

Submitter

Peter Anderson

Description

Medicare is converting their beneficiary identifiers from Health Insurance Claim (HIC) Number to Medicare Beneficiary Identifier (MBI). Today, we receive 834 enrollment transactions which contain an employer-assigned identifier in 2000/REF*0F*~ and the HIC Number in 2000/REF*F6*~.

Although code F6 is named ‘Health Insurance Claim (HIC) Number’ it is defined ‘Use when reporting Medicare eligibility for a member until the National identifier is mandated for use.’ We believe the F6 definition would still apply to the MBI and it is appropriate to send the MBI in 2000/REF*F6*~.

Can you confirm our interpretation or provide guidance on the preferred method of reporting the MBI in an 834?

Submitter Assigned Keywords

834 MBI

Response

The usage note on F6=Health Insurance Claim (HIC) Number in Loop 2000 Member Supplemental Identifier REF01 supports sending the identifier being used for the Medicare beneficiary, i.e. either the current HICN or the new Medicare Beneficiary ID (MBI).

Recommendation

When there is a need to send both a HICN and the MBI for a beneficiary, the MBI should only be sent using the ZZ=Mutually Defined qualifier and the HICN using the F6=HICN qualifier.

Trading partners are encouraged to confirm where each identifier will be sent in the trading partner agreement to ensure clarity and understanding by both parties through the MBI transition period.

Submission 9/1/2017
Status Date 11/3/2017
Status F - Final
Primary References
Document 005010X220
Set ID834
Loop2000
Segment IDREF