Claims Documentation: Make Sure a Beneficiary's Name Matches

The beneficiary name on a Request for Anticipated Payment (RAP) and on the Pre-Claim Review (PCR) must match in order for the final claim to pay. The beneficiary name should be listed exactly as it appears on the MBI card. If the beneficiary name does not match, the claim will not process.

Example 1
Beneficiary Name on RAP and PCR: John Smith
Beneficiary Name on Final Claim: Jonathan Smith

Result: The RAP and the PCR was submitted with the name of John, however, the final claim was submitted with the name of Jonathan. This claim will not process because the beneficiary names differ.

Example 2
Beneficiary Name on RAP and PCR: Jonathan Smith
Beneficiary Name on Final Claim: Jonathan Smith

Result: The beneficiary names match on all submissions (RAP, PCR and Final Claim), and the claim will process if payable.