From NGS Medicare Alerts:Prevent Claim Rejections: Beneficiary Name and Health Insurance Claim Number Must MatchIt has come to our attention that many providers in Jurisdiction K are submitting claims in which the beneficiary’s name and Health Insurance Claim Number (HICN), also known as the Medicare number, do not match.
To prevent claim rejections, please be sure that your office staff members use the beneficiary’s name and Medicare HICN exactly as it appears on the beneficiary’s Medicare card. Note: When claim(s) reject for MA130 and CO-16, it is the provider’s responsibility to submit a new claim with the correct information.
The HICN is shown on the beneficiary’s Medicare card and serves as the beneficiary’s identification number for Medicare entitlement.
The general formats of the Medicare number issued by the Social Security Administration (SSA) are nine-digit numbers with at least one letter suffix in the tenth position. If there is an eleventh position, it may be either a letter or number, (e.g. 123-45-6789A or 987-65-4321D4).Some Railroad Retirement Board (RRB) beneficiaries may have a number with a different format that may contain either a six- or nine-digit number with up to a three-position letter prefix, (e.g., A123456 or MA123-45-6789).
The Medicare Card
A Medicare card is issued to every person who is entitled to Medicare benefits. This card identifies the Medicare beneficiary and includes the following information:
- Name (exactly as it appears in Social Security records)
- Medicare HICN
- Beginning date of Medicare entitlement for hospital (Part A) an d/ormedical (Part B) insurance
- A place for the beneficiary’s signature