Action on Medicare Denial for Patient cannot be identified

Denial Reason of Medicare

CO 31 - Claim denied as patient cannot be identified as our insured
Description - (PATIENT'S HIC# NONENTITLED. SUBMIT A NEW CLAIM WITH VALID HIC#.)

Action on Medicare Denial for patient not identified

1: make sure that 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


2: Verify how the beneficiary’s name is listed on their Medicare card and place it that way on the claim (e.g., no nicknames)

3: Verify the beneficiary’s date of birth (DOB)

4: Ensure the numbers are not being transposed (possibly via software)

5: Verify for which part(s) of Medicare the patient is eligible

6: Check eligibility for beneficiaries using the IVR, Call (877) 847-4992; in the menu of eligibility.

7: Resubmit claim with correct Medicare number and patient name