Top Nuances to Know for the Medicare Card MBI Roll-Out

Check your patients' Medicare cards for MBIs

Medicare began mailing out new cards in April 2018 to meet the deadline of replacing Social Security numbers/Health Insurance Claim Numbers (HICNs) with Medicare Beneficiary Identifiers (MBIs) by April 2019. Here are some tips you may have missed to help you with the transition.

Don’t Use the Dashes!

On the new Medicare cards and in the training materials about the new MBI from Medicare, you’ll see the MBI formatted like this: 1EG4-TE5-MK73.

Important: Do not enter the dashes (hyphens) or any spaces as part of the number. In a July 2018 MLN Fact Sheet (ICN 909365), Medicare states that the dashes “won’t be entered into computer systems or used in file formats.

Check List of DOS Rules Before Using HICN

There is a transition period, but you should start using the MBI as soon as your patient receives it to ensure you work out all the kinks in your system. Beneficiaries in many locations (states, territories, etc.) already have their new cards. Keep in mind that beneficiaries who join Medicare April 2018 or later will have only an MBI, not an HICN.

Medicare will accept the patient’s old number until Dec. 31, 2019. Starting Jan. 1, 2020, you must use the MBI, even if the DOS was before Jan. 1. You read about this in our February blog post on MBIs, but it’s worth repeating because your claims will face issues if you assume the DOS is the deciding factor.

There are exceptions that will allow either the MBI or HICN:

  • Appeals and related forms
  • Claim status query
  • Span-date claims.

You should not use both the HICN and the MBI on the same claim. So if you don’t want to have to worry about learning the exceptions and the final deadline, stick to using the MBI as soon as it’s available.

Continue to Use Other Plans’ Cards When Appropriate

Medicare Advantage and Prescription Drug plans have their own identifiers, and you should continue to use those identifiers and cards for those services/claims.

Crossover news: You also may be interested in Medicare’s statement that the agency is working with other payers, Medicaid, and supplemental insurers to ensure the crossover claims process continues just as it does now.

What About You?

Have you seen the new cards coming into your practice yet? How is the transition going?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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