Use Medicare Beneficiary Identifiers (MBIs): Claim Reject Codes Beginning January 1

As you all know, there was a transition in new Medicare cards where CMS replaced the SSN-based HICN with Medicare Beneficiary Identifiers (MBIs). We, at MPS, would like to encourage all practices to use MBIs for all Medicare transactions. Not only will it get you paid, but it will protect your patient’s identities. According to CMS, failing to use MIBs on claims will result in: Electronic claims reject codes: Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber) Paper claims notices: Claim... read more

New TPA for New Mexico Health Connections starting January 1

New Mexico Health Connections (NMHC) has sent out their latest Winter 2019 newsletter. We, at MPS, wanted to bring to your attention an important update. NMHC will have a new Third-Party Administrator (TPA) effective January 1, 2020. They will be working with Friday Health Plans and they will end their Managed Services Agreement with True Health New Mexico. So, what do these changes mean? As of January 1, NMHC members will no longer be able to utilize the True Health New Mexico provider network. True Health New Mexico will continue to provide medical management services, billing services, and customer service to NMHC members through... read more