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The Injured Party Information page is step one of the New Claim process. Carefully enter required information about the injured party. Ensure that the values entered are correct as a transaction will be deducted from your allotted count whether a beneficiary is found or not. (Note: If a beneficiary is not found with the entered values, an error message will appear.)
Enter either a Medicare ID (Health Insurance Claim Number [HICN] or Medicare Beneficiary Identifier [MBI]) or SSN. The Medicare ID is preferred. 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 match is found for the Medicare ID or SSN, at least 3 out of 4 of these other personal characteristics must also match the beneficiary record for the injured party to be considered found. If you do not have the Medicare ID available, or are unsure of the validity of the Medicare ID, the SSN may be entered. You may choose to enter only the last 5 digits of the SSN instead of the full 9 digits.
Transactions Remaining: RREs are allotted 500 transactions per calendar year. This number represents the number of transactions still available for use. This counter will be automatically reset on the RRE’s anniversary of selecting DDE each year. If an RRE is approaching its 500th transaction and is in need of additional transactions, the RRE should contact their EDI representative.
Injured Party Information Fields
| Field | Description |
|---|---|
| Medicare ID or SSN | Enter the injured party's Medicare ID (HICN or MBI) assigned by Medicare or their SSN. Valid Medicare IDs may consist of up to 12 characters. If the Medicare ID is not available an SSN may be entered instead. Valid SSNs consist of 9 numeric digits or the last 5 digits of the SSN. Note: Medicare ID is also known as the Medicare Number to CMS’ Medicare beneficiaries. |
| First Name | Enter first name of the injured party. May contain letters A-Z or a-z and embedded spaces. Enter name as shown on Social Security card or Medicare card. |
| M.I. | Enter the first letter of the injured party’s middle name. Enter 1 alpha character. (Optional) |
| Last Name | Enter the last name of the injured 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. |
| Gender | Select the gender of injured party as Male or Female. |
| Date of Birth | Enter the birth date of the injured party. Enter numeric digits 0-9 in MM/DD/YYYY format. |
| Cancel | Click to return to the RRE Information Detail page. The information you entered will not be saved. |
| Continue | Click to submit information for verification. If the information is correct, continues to the next page of the process. If not, the Beneficiary Not Found error appears. |
September 2024
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