Last Modified: 12/7/2009
Location: FL, PR, USVI
Business: Part B
(PATIENT’S HIC# NONENTITLED. SUBMIT A NEW CLAIM WITH VALID HIC#.)
Resources/tips for avoiding this unprocessable claim
• If you are a laboratory, radiology department, or other entity to which the patient or their service(s) may have been referred, obtain a copy of the patient's Medicare card from the referring source prior to submitting your claim.
• Verify the information indicated below.
• Before submitting the claim, ensure you have a copy of the patient’s most recently issued Medicare card in order to compare the health insurance claims (HIC) number with the one you are submitting.
• Verify how the beneficiary’s name is listed on his/her Medicare card and place it that way on the claim (i.e., no nicknames).
• On the Medicare card, verify for which part(s) of Medicare the patient is eligible.
• Verify the beneficiary’s date of birth (DOB).
• Ensure HIC numbers are not being transposed (possibly via software) on claims.
• Check beneficiary eligibility for current and previous dates of service by using the
Part B IVR.
• Call (877) 847-4992; from the main menu, press “3,” then “1” for current eligibility.
• Eligibility may also be verified using the 270/271 HIPAA Eligibility Transaction System (HETS).
Click here 
for more information.
Tip to correct the unprocessable claim
Resubmit claim with a correct Medicare number and patient name.
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Source: FCSO Education Action Team
