New Medicare Cards Are Coming!

New Medicare Cards Are Coming!

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The Centers for Medicare & Medicaid Services (CMS) announced that under the Medicare Access and CHIPS Reauthorization Act (MACRA) of 2015, they are required to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status.

CMS has said the biggest reason they are taking the SSN off of Medicare cards is to fight medical identify theft for people with Medicare.

Timeline for New Medicare Cards

Beginning in April 2018, CMS will start mailing the new Medicare Cards with the MBI to all people with Medicare in phases by geographic location. The change to MBIs won't change how they find Medicare non-active Medicare beneficiaries.

The MBI and the HICN don't tell CMS which beneficiaries are non-active, so they'll keep using the data that does give them that information.

CMS will be having a transition period that will begin no earlier than April 1, 2018 and will run through December 31, 2019. During that time you can use either the HICN or MBIs to exchange data with CMS.

After the transition period ends on January 1, 2020, you'll need to use MBIs on your claims with a few exceptions when you can use either the HICN or MBI.

Medicare plan exceptions

  • Appeals You can use either the HICN or the MBI for claims appeals and related forms.
  • Adjustments You can use the HICN indefinitely for some systems (Drug Data Processing, Risk Adjustment Processing, and Encounter Data) and for all records, not just adjustments.
    • Reports CMS will use the HICN on these reports until further notice:
      • IncomingtoCMS (quality reporting, Disproportionate Share Hospital data requests, etc.)
      • OutgoingfromCMS (Provider Statistical & Reimbursement Report, Accountable Care Organization reports, etc.)

Fee-for-Service claim exceptions

  • Appeals You can use either the HICN or the MBI for claims appeals and related forms.
  • Claim status query You can use either the HICN or MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you're checking the status of a claim with a date of service on or after January 1, 2020, you have to use the MBI.
  • Span-date claims You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health (home health claims & Request for Anticipated Payments (RAPs)), and 41X-Religious Non-Medical Health Care Institution claims if the "From Date" is before the end of the transition period (12/31/2019). You can submit claims received between April 1, 2018 and December 31, 2019 using the HICN or the MBI. If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before December 31, 2019, but stops getting those services after December 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019.
  • Incoming premium payments People with Medicare who don't get SSA or RRB benefits and submitpremium payments should use the MBIon incoming premium remittances. But, CMS will accept the HICN onincoming premium remittances after the transition period. (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.)

How will the MBI look?

The MBI will be:

  • Clearly different than the HICN and RRB number
  • 11-characters in length
  • Made up only of numbers and uppercase letters (no special characters)

Each MBI is unique,randomly generated, and the characters are "non-intelligent," which means they don't have any hidden or special meaning.

New Medicare Card