What CMS' new Medicare cards mean for providers: 7 things to know

CMS will begin mailing new Medicare ID cards to roughly 58 million beneficiaries next April to meet the Medicare Access and CHIP Reauthorization Act deadline to remove Social Security numbers from  all cards.

Here are seven things providers need to know about the new cards, according to CMS.

1. Providers must change practice management systems to accept new Medicare beneficiary identifiers (MBI) by April 2018 for billing, claims status and eligibility status transactions. The MBI will be a randomly-assigned 11-character identifier comprising numbers and uppercase letters.

2. Providers using vendors to bill Medicare will need to verify vendors' MBI practice management system changes.

3. CMS will enact a transition period beginning April 2018 through December 2019 during which providers can use either MBIs or SSN-based health insurance claim numbers (HICN) to file claims. Beginning in October 2018, CMS will return HICNs and the MBIs on each remittance advice for providers who submit a claim using an SSN-based HICN.

4. Members can up look up their MBI in April 2018 through secure web interfaces. Providers will be able to do the same June 2018.

5. Providers should verify addresses they have on file for Medicare beneficiaries match electronic eligibility transaction responses from CMS. Patients with differing addresses will need to contact the Social Security Administration to make a correction. 

6. CMS is developing material for providers to give to patients as reminder to use the new cards. The agency encourages providers to work with primary care physicians or referring facilities if patients and their caregivers are unable to provide their MBIs.

7. CMS released a first look at the MBI-based cards Sept. 14.

To access a sample letter CMS sent to providers about the transition, click here.
To access a fact sheet about how providers can prepare for the new cards by April 2018, click here

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars