Medicare AdvantageAdministrativeHigh impact
Claim Filing Indicator “16” Should be Used if member has a Medicare Part C Policy
Mississippi Medicaid (DOM)·MS·Claims & Billing
We identified it
Jun 21, 2026
Summary
Medicare Part C claims must now include Claim Filing Indicator '16' in the 2320 loop (SBR09 field) when submitting 837 electronic claims to MESA. This ensures proper crossover claim processing and prevents incorrect payment or processing errors.
Action Required
Immediately: Billing team must update electronic claims submission system to include Claim Filing Indicator '16' in the 2320 Other Subscriber Loop (Data Element SBR09) for all Medicare Part C claims submitted via 837 5010 X12 transaction files to MESA. Verify billing software automatically populates this field when Medicare Advantage is the payer. Failure to include this indicator will result in incorrect claim processing and payment.