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News & Press: Government Affairs News

Medicare Transition to MBI Ends December 31

Thursday, December 5, 2019   (0 Comments)
Posted by: Bradley Coffey, MA, AAOE Government Affairs
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Baltimore - The 21 month transition period for the use of new Medicare Beneficiary Identifiers (MBIs) is ending on December 31, according to a special edition of MLN Connects. Starting January 1, claims not using the new MBIs will be rejected, as will eligibility transactions. 

Patient MBIs can be obtained from the patient's Medicare card or from your Medicare Administrative Contractor's (MAC) provider portal (a list of MACs and their portals may be found here). As of December 3, 86% of Medicare physicians were using the new MBIs.

The old Social Security Number-based Health Insurance Claim Numbers (HICN) from old Medicare cards may continue to be used by physicians in the following cases:

  • Appeals - You can use either the HICN or the MBI for claims, appeals and related forms.
  • Audits – You can use either the HICN or the MBI for audit purposes.
  • Claim status query - You can use either the HICN or the MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you're checking the status of a claim with a date of service on or after January 1, 2020, you have to use the MBI.
  • Span-date claims - You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health (home health claims & Request for Anticipated Payments (RAPs)), and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before the end of the transition period (12/31/2019). You can submit claims received between April 1, 2018 and December 31, 2019 using either the HICN or the MBI.  If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before December 31, 2019, but stops getting those services after December 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019.
  • Incoming premium payments - People with Medicare who don't get Social Security Administration (SSA) or Railroad Retirement Board (RRB) benefits and submit premium payments should use the MBI on incoming premium remittances. CMS will accept the HICN on incoming premium remittances after the transition period.  (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.).

Medicare Advantage (MA) patients will continue to use their existing MA and/or Medicare drug plan cards.

 

Train Your Staff: Ensure that all staff are trained to identify MBIs so they can recognize them and don't accidentally use an HICN for a claim with a "From Date" after January 1, 2020.

  • MBIs are clearly different from the HICN and RRB numbers.
  • MBIs are 11-characters in length; and,
  • MBIs are made up of only numbers and uppercase letters (no special characters)

Use this document from CMS to help train your staff on recognizing the new MBIs.


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