Billing Beat

Change In Claim Edits

March 1, 2005

In October 2004, CMS made a software change to require an exact match on beneficiary First Initial, Surname, and Health Insurance Claim Number submitted on the claim. Since this change was implemented the number of denials because of name/number mismatch tripled. To resolve these claim denials, providers should bill using the name and number as it appears on the beneficiary Medicare card.

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