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5 Things Providers Need to Know About the New Medicare Cards

By Debra Shute  
   September 25, 2017

Providers must fully transition to using beneficiaries’ new numbers by January 1, 2020, but there are several steps to take in the meantime.

The Centers for Medicare & Medicaid Services (CMS) will begin mailing the newly designed Medicare card to beneficiaries in April 2018 to meet the deadline for replacing all existing Medicare cards by April 2019 under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

The new cards will assign each beneficiary a unique, randomly assigned number, known as a Medicare Beneficiary Identifier (MBI), which replaces the current Social Security Number–based Health Insurance Claim Number (HICN).

The new design was revealed to the public on September 14, 2017. People with Medicare will also be able to see the design of the new Medicare card in the 2018 Medicare & You Handbook, copies of which will reach beneficiaries throughout September.

“The goal of the initiative to remove Social Security numbers from Medicare cards is to help prevent fraud, combat identity theft, and safeguard taxpayer dollars,” said CMS Administrator Seema Verma in an announcement about the change.

Related: 5 Ways to Prepare for New Medicare Card Numbers

Although there will be a 21-month transition period during which CMS will recognize either the old or new number, providers should quickly begin to consider the following:

1. Don’t wait to examine your practice management systems and business processes to determine what changes may be needed to use the MBI, CMS advises. You’ll need to make those changes and test them by April 2018. If you use vendors to bill Medicare, contact them to find out about their MBI practice management system changes.

2. In April 2018, people with Medicare will be able to look up their new MBI numbers; and in June 2018, providers will also be able to look up their patients’ MBI numbers through secure Web interfaces.

3. Beginning in October 2018, through the transition period, when you submit a claim using your patient’s valid and active HICN, CMS will return both the HICN and the MBI on every remittance advice. The MBI will be in the same place you currently can view the “changed HICN.”

4. CMS is creating materials to give patients to remind them to bring their new Medicare cards to appointments. If patients or their caregivers can’t provide MBIs, providers are asked to work with primary care doctors or referring facilities to obtain the patient information they need.

5. In the meantime, if the address you have on file is different than the address you get in electronic eligibility transaction responses, ask your patients to correct their address in Medicare’s records by contacting the Social Security Administration. This may require coordination between your billing and office staff.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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