Patient Cannot Be Identified

CARC/RARC Description
PR-31 The patient cannot be identified as our insured.

 

Common Reasons for Message

  • Patient does not have Medicare Part B entitlement

Next Step

  • Verify patient has Medicare Part B entitlement
  • If patient has Medicare Part B benefits, resubmit claim
  • Claim must contain the following information exactly as indicated on their Medicare card:
    • Medicare Beneficiary Identifier (MBI) number
    • First and last name (in proper order)
    • If patient has two last names or hyphenated last name, submit each character exactly as it appears on the Medicare card

Claim Submission Tips

  • Obtain patient's full name and Medicare Beneficiary Identifier (MBI) number directly from their most current Medicare card
    • Keep a copy on file
  • Prior to submitting claim(s), verify patient's eligibility via the Interactive Voice Response (IVR) or the Noridian Medicare Portal (NMP)
    • Be sure patient's date of service falls within their Part B entitlement dates
  • If patient sees a problem or has an error on his/her Medicare card, they must contact Social Security Administration (SSA) at 800-772-1213 to make necessary correction(s)

 

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