Do you have your insurance card? Asking this question is a routine practice when patients present at a provider’s office or facility. It is not uncommon for insurance companies to issue new cards with a new contract year.

This year is a little different for our Medicare patients. Medicare has been in a transition period since April 1, 2018 to replace the social security number as a patient identifier. This transition ends December 31, 2019 and effective January 1, 2020 the individual identification number, known as the MBI (Medicare Beneficiary Identifier) will replace the social security numbers used for decades. This will increase the security for our patients but may require extra attention for those at the front desk who schedule and check in our patients.

The MBI will be an 11-character alpha-numeric identifier that has been randomly generated. This is similar to the Health Insurance Claim Number (HICN) and will not contain dashes as the SSNs have in the past. Each patient, including spouses or dependents will receive their own MBI.

If the patient doesn’t have their new card or isn’t aware of this new process, you can use your Medicare Administrative Contractor’s (MAC’s) secure MBI look-up tool. You will need to sign up for the MAC portal, and have the patient’s SSN to use this tool, but even if your patients are in a Medicare Advantage Plan, you can find their MBIs.

Practice EHR Changes to Accommodate MBI
Each remittance that you receive from Medicare will also contain the patient’s MBI allowing you to update the patient’s insurance screen of Practice EHR.

Exceptions
Effective January 1, 2020 the MBI must be submitted on all claims with the following exceptions:

• Appeals – you may file an appeal with either the HICN or the MBI
• Claim status query – you may use either the HICN or MBI to check the status of claims with a DOS prior to January 1, 2020.
• Adjustments – the HICN can be used indefinitely for Drug Data Processing, Risk Adjustment Processing, and Encounter Data
• Reports coming into/out of CMS – Quality Reporting, ACO reports, Provider Statistical & Reimbursement report, etc.

Other exceptions can be reviewed on CMS.gov. If we can be of further assistance, or help you learn more about this requirement send us a message.