One of the requirements of the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, was the removal of Social Security numbers from all Medicare cards by April 2019. The principal reason is to protect people with Medicare from identity theft.
Starting in April 2018, CMS will begin mailing new cards with Medicare Beneficiary Identifiers (MBIs) to all beneficiaries. The new MBIs will have 11 digits, including only numbers and uppercase letters. Although the cards will include hyphens, they will not be used for claims. The new identifiers will be randomly generated and are not based on Social Security numbers.
There will be three ways for practices to obtain the new MBIs for their patients: The patient can present with the new card, the practice can receive the MBI on a remittance advice, or the practice can obtain it through a secure portal with its Medicare Administrative Contractor (MAC).
The mailing schedule will be primarily based on geography, beginning in April with the mid-Atlantic states, California, Oregon, Hawaii, Alaska, and the Pacific territories. (Learn more about the mailing schedule.) Also starting in April 2018, Medicare patients can look up their new MBI and check the status of card mailings in their area on Medicare.gov.
During the transition period between April 2018 and December 2019, claims can include either the old Health Insurance Claim Number (HICN) or the new MBI. However, patients who are new to Medicare will receive only the new identifiers on their cards regardless of geography, so practices need to be ready to use the MBI on claims and other correspondence beginning in April. Clinicians will be able to look up patient MBIs on MAC secure portals beginning in June 2018.
CMS will provide Medicaid agencies and supplemental insurers with the new numbers before the cards are mailed. Crossover claims can use either HICN or MBI during the transition period. The new identifiers also apply to Railroad Retirement Board (RRB) beneficiaries, and the cards will continue to use the RRB logo.
Beginning in October 2018, when practices submit a claim with the HICN, CMS will return both the HICN and the MBI on every remittance advice. Practices should contact all business vendors (e.g., EHR, practice management system, billing company) to make sure they are ready. If possible, since it is inevitable that some patients may not provide their new cards or numbers, set up systems to automatically accept the MBI from the remittance advice. The transition period is scheduled to end December 2019, after which all claims must use only the MBI.
To see what the new cards will look like and for more information about the transition, go to the new Medicare card home page. Practices are urged to remind patients to look out for their new cards in the mail and to be sure to bring them to their next appointments. It is important during this time to verify patient addresses to make sure they match the electronic eligibility transactions. If they are different, encourage your patients to update their addresses with Medicare. Remind patients that they should protect their new numbers like they would a credit card and that Medicare will never contact them to ask for personal information.
Go online for more information, including posters and patient handouts in English and Spanish for use in the office.