Action – CO 31 Claim denied as patient cannot be identified as our insured
Description – (PATIENT’S HIC# NONENTITLED. SUBMIT A NEW CLAIM WITH VALID HIC#.)
Tips and Resources
• Ensure you have a copy of the patient’s most recently issued Medicare card in order to compare that number with the one you are submitting
• Verify how the beneficiary’s name is listed on their Medicare card and place it that way on the claim (e.g., no nicknames)
• Verify the beneficiary’s date of birth (DOB)
• Ensure the numbers are not being transposed (possibly via software)
• Via the Medicare card, verify for which part(s) of Medicare the patient is eligible
• Check current and previous dates of service eligibility for beneficiaries using the IVR. Call (877) 847-4992; from the main menu, press “3,” then “1” (current eligibility).
• Resubmit claim with correct Medicare number and patient name
