Date: June 16, 2021
To: All Medical Assistance Program Providers
Re: Medicare Beneficiary Identifier (MBI) Field
Completion for 837P Crossover Claims
This notice informs providers of a new claim completion requirement
related to the Medicare Beneficiary Identifier (MBI) on Medicare crossover 837P
claims. This requirement applies to fee-for-service claims for patients
enrolled under both Original Medicare and Medicare Advantage Plans. The new billing
requirement only impacts 837P claims submitted through a clearinghouse, not
those submitted through the MEDI system.
An HFS change in mapping of the MBI was necessary to allow tertiary
claims to adjudicate correctly. Due to the mapping change, 837P crossover claims
that are submitted through a clearinghouse must identify claim filing indicator
code “MB” (for Medicare B) in Loop 2320, Segment SBR09. The actual MBI
continues to be entered in Loop 2330A, Segment NM109.
Providers must inform their vendors of this mapping change. Claims that
do not contain the claim filing indicator code “MB” will be rejected with error
code K22 – MBI Does Not Match # on File.
Special Note for Providers of Encounter Clinic Services Who Bill
Medicare Primary on the Institutional Claim Format:
Providers who are required to bill Medicare as the primary payer on the
institutional claim format must change the
claim filing indicator “MA” to “MB” in Loop 2320, Segment SBR09 of the 837P
before billing Medicaid as the secondary payer.
Questions regarding this notice may be directed to a billing consultant
in the Bureau of Professional and Ancillary Services at 877-782-5565.
Kelly Cunningham, Administrator
Division of Medical Programs
