Denial Code Decoder
MA27 — Member entitlement number problem
The patient's entitlement or member identifier on the claim is missing or invalid — for Medicare, usually a wrong or outdated Medicare Beneficiary Identifier (MBI). The coverage may be fine; the number on the claim is not.
Billable to the patient? No — correct the identifier and resubmit first.
Where this denial is born
- Front desk
- Coding
- Claim build
- Submission
- Adjudication
This denial is usually created at the highlighted stage — that is where prevention lives.
Answer the questions — follow the path
The same questions an experienced biller asks, in order. Your answers draw the route to the right action.
Does an eligibility check return the current, valid member ID?
The full decision tree
Does an eligibility check return the current, valid member ID?
- Yes →
Correct the member ID and resubmit. Update registration with the identifier from the eligibility response and resubmit the claim.
- No →
Confirm coverage with the patient. The coverage itself may have changed — verify with the patient and their payer, then update registration and resubmit to the right plan.
Prevention
Run an eligibility check at every visit and let it correct the member ID on file — identifiers change (MBIs can be reissued) and cards go stale.
Related reading
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