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Last Modified: 11/11/2019 Location: FL, PR, USVI Business: Part B, Part A

JN MBI submission rate for October is below target of 90% -- act now to prevent payment delays

The Medicare Beneficiary Identifier (MBI) submission rates in October for Jurisdiction N are below the target goal of 90%. A breakdown of the current submission rates are:
Florida: 78% for Part A and 79% for Part B
Puerto Rico: 66% for Part A and 75% for Part B
U.S. Virgin Islands: 66% for Part A and 75% for Part B
Recall you must submit only the MBI on Medicare claims starting January 1, 2020, regardless of the date of service. If not, Medicare will reject claims submitted with the health insurance claim number (HICN), with a few exceptions. This means your payments will be delayed causing you unnecessary rework to correct and resubmit the claim.

Act now to avoid payment delays in January

Providers should bill the MBI now to prevent claim and payment impacts in January. Take these actions to obtain the MBI:
Ask your patient for their new Medicare card. If they don’t have it, they have the option to call 1-800-MEDICARE (1-800-633-4227) or print their card from external link.
Obtain the MBI from First Coast’s MBI lookup tool on our Secure Provider Online Tool (SPOT). If you’re not registered for SPOT, now is the time to do so. Here is how to register for SPOT.
Check your remittance advice for the MBI. The MBI is currently returned on the remittance advice for every claim submitted with a valid and active HICN through December 31, 2019. Starting January 1, 2020, claims will reject at the gateway, therefore you will no longer have the option for obtaining the MBI from the remittance advice.

Verify your clearinghouse or vendor are submitting the MBI

If you use a clearinghouse or vendor to submit your Medicare claims, verify they are submitting with the MBI. If you send your claims to them with the MBI, but both the HICN and MBI are returned on your remittance advice, then they are not submitting your claims with the MBI.
In our outreach, we speak to many providers who aren’t aware if their vendor is billing the MBI or not. Payment delays will impact you so it’s important you work closely with them to ensure they submit the claims with the MBI.

Do you refer or order for Medicare patients?

When you write an order or refer a patient for a service or treatment, use your discretion and share the MBI number with lab or diagnostic facilities you are referring to, especially when they do not see the patient. Also, consider sharing the MBI with skilled nursing facilities for transfers between facilities, and ambulance transport providers when you’re arranging patient transport.

Stay tuned

We’ll continue to update you on the JN MBI submission rate as we near the implementation date. Please share this information with your facility or office today and take the appropriate actions to increase your MBI submission rate.

Additional MBI resources

New MBI Get it, Use it – MLN Matters® SE 18006 external pdf file
Looking for an MBI? Use the MBI lookup on SPOT – click here to register
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.