When checking Medicare eligibility in Claim.MD, the patient's Medicare Beneficiary Identifier (MBI) must be entered in the Policy/Member ID field. If the patient's MBI has changed, you will need to update the patient or claim record with the current MBI before checking eligibility again.
What if the Patient's MBI Has Changed?
If you submit an eligibility request using an outdated MBI, Medicare may return the patient's updated MBI in the eligibility response.
- If Medicare returns the new MBI: Update the patient or claim record with the new MBI and use it for future eligibility checks and claim submissions.
- If Medicare does not return the new MBI: You will need to obtain the current MBI from the patient's Medicare card or the appropriate Medicare or Medicare Administrative Contractor (MAC) portal.
Important: Claim.MD cannot independently look up or retrieve a patient's updated MBI if Medicare does not provide it in the eligibility response.
How to Check Medicare Eligibility in Claim.MD
Once you have the patient's current MBI, follow these steps to check Medicare eligibility:
- From the left navigation menu, select Eligibility.
- Select the appropriate Provider.
- Select the applicable Medicare payer.
- Choose the appropriate Benefit Type.
- Enter the patient's information, including the current MBI in the Policy/Member ID field.
- Click Check Eligibility to submit the request.
Tip: If Medicare provides an updated MBI in the eligibility response, be sure to update your patient records so future eligibility requests and claims use the correct identifier.