Designed to help protect the privacy of Medicare recipients, a new Medicare Beneficiary Identifier (MBI) will replace the social security number-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim FISS/DDE submissions starting April 1, 2018.

Beginning in April, CMS will mail new Medicare cards to all people with Medicare on a flow basis by geographic location and other factors.

Wave 1 (Cards mailed April – June 2018): DE, DC, MD, PA, VA, WV
Wave 2 (Cards mailed April – June 2018): AK AS, CA, GU, HI, MP, OR
Wave 3 (Cards mailed after June 2018): AR, IL, IN, IA, KS, MN, NE, ND, OK, SD, WI
Wave 4 (Cards mailed after June 2018): CT, ME, MA, NH, NJ, NY, RI, VT
Wave 5 (Cards mailed after June 2018): AL, FL, GA, NC, SC
Wave 6 (Cards mailed after June 2018): AZ, CO, ID, MT, NV, NM, TX, UT, WA, WY
Wave 7 (Cards mailed after June 2018): KY, LA, MI, MS, MO, OH, PR, TN, VI

The transition period for this change is April 2018 through December 31, 2019. During this period, providers will be allowed to use either the HICN or MBI (but not both) to exchange data with CMS. However, any NEW Medicare cards issued will only have the MBI.

The Medicare Beneficiary Identifier will contain unique, randomly generated characters. It will be 11 characters in length and will be made up of numbers and uppercase letters. It will be clearly different from the HICN number. Medicare recipients will be able to begin using their new Medicare cards containing the new MBIs as soon as they get them.

Here are a few tips to ensure that your agency is ready to accept MBIs and avoid any loss of revenue.

  1. Make sure that your home health and hospice software has been updated. Check with your home health and hospice software vendor to find out if updates have been made to your software to enable you to accept and utilize MBIs on claims. You will want to be sure that the MBI flows into all OASIS documents, HIS assessments, and 485s. During the transition period, it is useful to have be able to record both the HICN and the MBI since there will be some time before all Medicare recipients receive updated cards.If you don’t have access to your MAC’s provider portal, sign up now so you can use a provider MBI look-up tool to be released in June 2018.
  2. Verify your Medicare patients’ addresses. If the addresses you have on file differ from the Medicare addresses you get on electronic eligibility transactions, tell your patients to contact the Social Security Administration and update their Medicare records.
  3. Educate your patients. Remind your patients that they will be receiving new Medicare cards and ask them to notify you when they are received. This enables your staff to collect the MBI from the patient as quickly as possible. CMS has a number of resources you can use to communicate the transition to your patients.
  4. Educate your staff. Make sure that your staff is aware of this change in identifier on the Medicare card. This allows you to be proactive in reaching out to patients to collect the MBI. You may want to consider rolling out a process for your team to facilitate to the collection of the new identifier.

It is very important that your home health or hospice agency is ready to accept the Medicare Beneficiary Identifier to ensure a clean claims process and maximized revenue.

The HEALTHCAREfirst Difference

HEALTHCAREfirst customers can rest assured that updates have been made to firstHOMECARE and firstHOSPICE to integrate MBIs into documents and claims as necessary. If you are not a customer and are interested in learning more about how our software can keep you in compliance with this and other regulatory changes.

Contact us to learn more!