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Beneficiary Lookup

Updated over a week ago

Overview

To help expedite beneficiary detail confirmation, a beneficiary lookup pilot has been launched on the Spark platform.

Beneficiary Lookup Process

The new beneficiary lookup feature is located under Add contact.

Please note that, for compliance reasons, this feature is only available for new contacts.

If the agent chooses to use the beneficiary lookup, they will be shown a script that must be repeated to the beneficiary. The agent must then input the beneficiaries agreement.

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If the agent selects to use the Medicare Beneficiary Identifier (MBI), they will be prompted to enter the information.

Otherwise, the agent can use the SSN. Providing the SSN will populate the MBI along with all other info.

Note: The SSN is not stored permanently; it is only used for the request and then removed from our records.

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After submitting the SSN or MBI, the agent will see the initial contact data and any available LIS data that CMS has on file for them. This data supersedes any data they may have already input; however, the agent can edit this saved data. The add contact flow then proceeds as normal.

Once the contact is created, agents will then be able to view the rest of the data, such as Plan history and Additional beneficiary details, which will include entitlement and eligibility periods, uncovered months, and any other LIS history.

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Troubleshooting

MBI Lookup

Error: Invalid Beneficiary Identifier

What it means: The system couldn’t find the beneficiary because the MBI, HICN, or RRB number entered is invalid.

Action: Double-check the number and try again.

Error: "BEQ lookup Failed. Please try again later”

What it means: This is a temporary system error.

Action: Wait 2 minutes, retry the request.

Error: “We are experiencing a high volume of requests. Please try again later”

What it means: This is a temporary system error.

Action: Wait 2 minutes, retry the request.

Other Contact Information Lookup

Error: No MBI Found

What it means: The person exists in the system, but no Medicare Beneficiary Identifier (MBI) is available. This often happens if the MBI was recently issued or updated within the last 60-90 days.

Action:

  • Use SSN to help locate the MBI.

  • Verify the client’s information is correct.

  • If the issue persists, try using MARx or a different carrier portal lookup.

Error: Request to MBIInquiry API timed out.

What it means:

  • The system is temporarily down

Error: Request to MBIINquiry API failed previously with provided data

What it means: The system couldn’t locate a matching person, usually due to incorrect input.

Action:

  • Confirm spelling of first/last name.

  • Try with or without suffixes (e.g., “Jr” vs. “Jr.” or no suffix).

  • Use SSN

  • 5-6% of the time, the beneficiary has a recently issued Medicare number or recently reissued (60-90 days). This means the beneficiary will not be pulled.

Error: “BEQ Lookup Failed”

What it means: Temporary processing issue.

Action: Wait a few minutes, retry the request.

Best Practices

  • Always confirm basic details first:

    • First Name

    • Last Name

    • DOB

  • Try inputting the SSN

  • For suffixes, try multiple variations (with/without “Jr”, no period, etc.).

  • If the error is unclear, retry — many issues resolve on the second attempt.

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