Medicare administrative contractor (MAC) Palmetto GBA is alerting providers to an issue where agencies are failing to log when a new Medicare Beneficiary Identifier is assigned to a patient.
“Home Health Notice of Admissions (NOAs), Hospice Notice of Elections (NOEs) and claims are required to be submitted with the current MBI or they will be returned to the provider for correction,” the MAC notes. “With the five-day requirement to submit NOAs and NOEs, it is important to verify the MBI is valid. Invalid MBIs submitted on NOAs or NOEs may cause them to be late and receive a late submission penalty.”
Palmetto highlights three scenarios where home health agencies have found trouble with new MBIs.
- The NOA processed under the old MBI. The NOA does not need to be canceled and resubmitted under the new MBI. The HHA needs to enter the new MBI on all future billing on or after the effective date of the new MBI. The HHA must also update the OASIS, if needed, to ensure the MBI on the OASIS and claim match.
- The admission period has started and the NOA and period of care claim(s) processed under the old MBI. Everything processed in the Medicare claims system remains — there is no need to cancel the claim(s) or NOA in order to resubmit under the new MBI. All billing on or after the effective date of the new MBI must be submitted with the new MBI. HHAs must ensure the MBI on the OASIS matches the new MBI billed on the claims.
- Claim adjustments must use the current MBI, even if the original claim was submitted with an old MBI