Medicare denial and Action - Patient identification

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

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