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7 Things You Need to Do to Transition to New Medicare Cards


7 Things You Need to Do to Transition to New Medicare Cards

By: Ramesh Leelasankar, Revenue Cycle Management Manager

Have you begun preparations to accept the New Medicare card? If not, you should consider planning for the upcoming launch.

The official transition period begins in April 2018 and runs until December 2019. Effective January 1, 2020, it is mandatory to ONLY use these new cards with updated identification numbers. To ease you into this potentially stressful change, we’ve condensed CMS’s latest informational packet down to the most important facts so you can begin prepping.


Why is Medicare Changing their ID Formats?

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandates the removal of Social Security Number-based HICN from Medicare cards to address current risk of beneficiary medical identity theft.

What Will Change? What is MBI?

Medicare is introducing the Medicare Beneficiary Identifier (MBI) with Non-Intelligent Unique Identifier. The identification will contain 11 characters of letters and numbers. Characters two, five, eight and nine will always be a letter. Characters one, four, seven, ten, and eleven will always be a number. Dashes will not be entered into computer systems or file formats, but exist to serve as visual guides.

Who Does It Apply To?

It will apply to existing, currently active, deceased or archived beneficiaries, and new beneficiaries enrolling in Medicare services. Those who also have a Medicare Advantage or Part D plan will receive a separate card from those insurers. If your patients have multiple plans, advise them to carry all cards in case of emergency.

Action Plan for Physician Offices, Private Practitioners and Billing Departments:

    1. Check the capability of your EHR/PM systems to accept the new MBI format. Validations in the existing HICN number should be removed so that the system can accept both MBI, as well as HICN.

    2. Circulate a memo to all practice staff explaining the MBI change, and train them to read and accept the new MBI cards.

    3. In April 2018, place fliers or notices for patients in the front office so they understand that you are ready to accept MBI cards.

    4. Effective June 2018, your front office or billing staff can use the CMS “Provider Lookup Tool” to get a patient’s MBI number, even if they have not updated you on it.

    a. You will need the patient’s first name, last name, DOB and SSN to identify the MBI from the “Provider Lookup Tool.”

    5. From October 2018 through December 2019, when a valid and active HICN is submitted on Medicare fee-for-service claims, both the HICN and the new MBI will be returned on the remittance advice. Check with your practice management system or clearing house vendor to confirm if they will be able to automatically update the MBIs from the received remittances.

    6. Effective November 2018, patients are mandated to either show their MBI cards or provide the four elements above for office staff to retrieve their number in the “Provider Lookup Tool.”

    7. Also starting in November 2018, you can run patient lists with outstanding claims to make sure the MBI numbers are updated on all of the accounts.

To begin preparations, Saisystems Health advises you to start early. Completion of these activities even a day past the January 1, 2020 deadline will lead to Medicare rejecting your claims. Team up with our revenue cycle management team and build your new Medicare card acceptance plan today! Call Sam at 203-567-5260 or email at smanns@health.saisystems.com.

For further reading from CMS, check out:
NMC Homepage
NMC Overview