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Preparing your practice for new medicare beneficiary IDs

October 1, 2019

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) goes into full effect in April 2019, so now is a good time to start preparing for it. Since Social Security Numbers (SSN) will no longer be a means of identifying patients, updating your physician practice management systems and processes will be imperative to keep your business running smoothly.

If you’ve not done so already, you’ll have to test your system to see if you must update it accordingly to accept the new patient numbers, which are called Medicare Beneficiary Identifiers (MBIs). Work with your billing staff (a professional medical billing service like Coronis can also help) to ensure that you’re adequately prepared.

What’s Behind This New Medicare Beneficiary ID Change?

In replacing SSNs on the new Medicare cards, the MBIs will show data like eligibility and claim status as well as billing information.

The main reason for this change is to protect people with Medicare against medical identity theft. This will help keep your patients’ private healthcare and financial information safe. It will also ensure that their federal health care benefit and service payments will not be at risk.

How will the MBI look?

The MBI characters have no meaning, as each will be unique and randomly generated. The characters are considered “non-intelligent;” there is no hidden or special meaning.

Characteristics of the MBI include:

  • A clear distinction between the HICN and RRB numbers
  • 11 characters
  • Composed only of numbers and uppercase letters
  • No special characters

Should a lowercase letter be used, the system will convert them to uppercase.

To learn more about the specifications for the MBI format to make the necessary medical billing system changes, Coronis can help make the transition smooth.  

Prepare Now During This Transition Period

During this period, the Centers for Medicare & Medicaid Services (CMS) will begin mailing the new cards with the MBI in phases to people with Medicare.Currently, we’re in the transition period, which began April 1, 2018, and ends December 31, 2019. This means either the HICN or the MBI can be used, though we suggest preparing now and converting as soon as you can.

For efficient physician practice management, we recommend that you start asking your patients if they have their new Medicare cards. If they do, you’ll have to update their beneficiary numbers in your system to ensure automatic acceptance. If they have not yet received their new cards, be sure to verify their address; otherwise, they likely will not receive them.

Effective January 1, 2020

Although your patients’ new MBIs are effective as soon as they receive their new card, the full implementation does not begin until January 1, 2020. Patients should start using their new cards/MBIs once they receive them.

That’s why, despite full implementation being more than a year away, we recommend that you not delay in testing your practice management system and business processes so you’ll know which changes you should make.

Beginning January 1, 2020, you’ll have to submit claims using MBIs (with very few exceptions), regardless of the date that you provided care or service. Learn more about MBIs at CMS.gov.

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