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Section 111 Mandatory Reporting Application (MRA)
Beneficiary Lookup
Carefully enter required information about the insured party. A transaction will be deducted from your allotted count even when mistyped values cause a match to not be found.
Enter either the Medicare ID (Health Insurance Claim Number [HICN] or Medicare Beneficiary Identifier [MBI]) or SSN. If both are entered the Medicare ID will be used for the search. For the SSN, NGHP and GHP reporters may enter either the full 9 digits or the last 5 digits.
Since Medicare IDs can change for a particular beneficiary the lookup can result in a match but a different Medicare ID may be returned.
The first initial of the first name, first six characters of the last name, gender, and date of birth comprise the secondary part of the match. Once a record is found for the Medicare ID or SSN, then at least 3 out of 4 of these other personal characteristics must also match the beneficiary record for the insured party to be considered a match. If you do not have the Medicare ID available or are unsure of the validity of the Medicare ID, the SSN may be entered instead; NGHP and GHP reporters may enter either the last 5 or the full 9 digits.
Transactions Remaining – NGHP RREs that have not selected the Direct Data Entry (DDE) reporting option are allotted 500 transactions per month. This number represents the number of transactions still available for use. This counter will be automatically reset each month. Requests for additional transactions should be directed to your EDI representative. GHP RREs can submit an unlimited number of queries.
Beneficiary Lookup
| Field | Description |
|---|---|
Medicare ID |
Enter a HICN or MBI. Valid Medicare IDs may consist of up to 12 characters. If a Medicare ID is not available, an SSN may be provided instead. |
SSN |
Enter the insured party’s Social Security Number. Only required if a Medicare ID is not available. Enter the full 9 digits or the last 5 digits. |
First Name |
Enter first name of insured party. May contain letters A-Z or a-z and embedded spaces. Enter name as shown on Social Security card or Medicare card. (Required) |
Middle Initial |
Enter first letter of insured party's middle name. Enter 1 alphabetic character (Optional) |
Last Name |
Enter surname of insured party. May contain letters A-Z or a-z, hyphens, apostrophes and embedded spaces. Enter name as shown on Social Security card or Medicare card. (Required) |
Gender |
Select gender of insured party as Male or Female. (Required) |
Date of Birth |
Birth date of insured party. Enter numeric digits 0-9 in MM/DD/CCYY format. (Required) |
Prev |
Returns to the RRE Listing page |
Cancel |
Returns to the RRE Listing page without performing the lookup. |
Next |
Submits information for verification |
Use the Home link on the menu to return to the RRE Listing page.
July 2023