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Effective January 1, 2020 the Medicare Beneficiary Identification (MBI) is Required

November 18, 2019

Effective January 1, 2020 the Medicare Beneficiary Identifier (MBI) will replace the Health Insurance Claim Number (HICN). The number should be submitted in place of the HICN on the Health Care Benefit Inquiry (270), the Health Care Claim: Institutional and Professional (837) transactions submitted to MassHealth. This includes the corresponding Direct Data Entry (DDE) via the Provider Online Service Center (POSC) as well. Providers must include the new 11 digit MBI on all relevant transactions.

MassHealth will send the MBI on record for the following outbound transactions:

  • Health Care Benefit Response (271)
  • Health Care Benefit Enrollment and Maintenance (834)

MassHealth trading partners should have prepared for this transition by validating that any involved systems can support the submission and receipt of the alpha-numeric MBI in relevant transactions.

If you have any questions, please contact the MassHealth EDI team at 1-800-841-2900 or EDI@MAHealth.net.