Doctors writing down notes

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) required the Centers for Medicare & Medicaid Services (CMS) to remove Social Security Numbers (SSN) from all Medicare cards by April 1, 2019. The new Medicare Beneficiary Identifier (MBI) replaced the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards. This step was taken to protect Medicare recipients from fraudulent SSN use, which can lead to identity theft and illegal use of Medicare benefits. Wave mailing of the new Medicare cards began April 1, 2018.

Key things to know include:

  • Each MBI is randomly generated and has 11 characters consisting of letters and numbers.
  • The effective date of the new cards will remain the date each beneficiary was eligible for Medicare.
  • The new MBI won’t change Medicare benefits.
  • Beneficiaries may begin using their new MBIs as soon as they get them.
  • Claims can be submitted with either the HICN or MBI in the same field as the HICN.

Providers can’t submit both numbers on the same transaction.

  • Once the transition period ends on December 31, 2019, providers will use only the MBI on all claims.
  • Beginning in October 2018, every electronic remittance advice for claims submitted with a valid and active HICN will return with the new MBI.
  • The MBI is confidential just like the HICN so it will need to be protected as personally identifiable information and used only for Medicare-related business.
  • The CMS is creating an MBI look-up that will be available June 2018. If providers don’t already have access to their Medicare Administrative Contractor’s provider portal, they can sign up to use this new tool.

Here are some important dates to remember:

  • April 1, 2018: Wave mailing of new Medicare cards began
  • April 1, 2018–December 31, 2019: Transition period where either HICN or MBI can be submitted
  • June 1, 2018: New MBI look-up tool premieres on the CMS website
  • April 1, 2019: Statutory deadline for the CMS to replace all Medicare cards
  • January 1, 2020: Transition period ends, MBI must be used on all claims

Here are five steps providers can take today to help office staff during the transition:

  • Go to the CMS provider website and sign up for the weekly MLN Connects® newsletter.
  • Attend CMS quarterly calls to get more information. Calls are scheduled in the MLN Connects newsletter.
  • Verify all Medicare patients’ addresses. If the address on file is different from the Medicare address on electronic eligibility transactions, ask patients to contact Social Security and update their Medicare records.
  • Help Medicare patients adjust to their new Medicare card by displaying helpful information about the new Medicare cards in English and Spanish. Other helpful products to share, such as flyers and posters, are available here.
  • Test system changes and work with billing office staff to help the office be ready to use the new MBI format.

Have questions? Contact Monique or your trusted BKD advisor.

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