What to do if a Patient’s MBI Number Changes

Posted on Monday, November 25, 2019 1:52 PM

CMS sent out an update on the new Medicare cards that were sent out from April 2018 to April 2019.  Medicare beneficiaries can request a new MBI if it is compromised thru CMS.  If a provider receives an error code of AAA 72 which is “invalid member ID”, your patients MBI may have been changed. 

Reminders About Using the Old or New MBIs

Fee-For-Service (FFS) claims submissions with:

  • Dates of service before the MBI change date – use old or new MBIs
  • Span-date claims with a “From Date” before the MBI change date – use old or new MBIs
  • Dates of service that are entirely on or after the effective date of the MBI change – use new MBIs

FFS eligibility transactions when the:

  • Inquiry uses new MBI – we will return all eligibility data.
  • Inquiry uses the old MBI and request date or date range overlap the active period for the old MBI – we will return all eligibility data. We will also return the old MBI termination date.
  • Inquiry uses the old MBI and request date or date range are entirely on or after the effective date of the new MBI – we will return an error code (AAA 72) of “invalid member ID.”

Source: NAHC Report


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