CMS’ New Medicare Cards (MBI) – Get Ready for It!

by | Last updated Nov 15, 2023 | Published on Jul 11, 2017 | Medical Billing

Medicare Cards (MBI)
Share this:

Based on the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015’s requirement, the Centers for Medicare & Medicaid Services (CMS) recently announced that they would provide new member ID cards for its beneficiaries. Healthcare providers as well as medical billing companies they employ should prepare their systems to accept the new format.

The agency will replace Health Insurance Claim Numbers (HICN) or Social Security Numbers (SSNs) with Medicare Beneficiary Identifiers (MBI) by April 2019. The replacement will be done on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status. The major reason behind the removal of SSN from Medicare cards is to fight medical identity theft for people with Medicare. Also known as Social Security Number Removal Initiative (SSNRI), the mission aims at protecting Private health care and financial information, Federal health care benefit and service payments.

While HICNs are the beneficiary’s 9-digit Social Security Number with a one or two-byte alphanumeric Beneficiary Identification Code, MBIs will be 11 bytes, alphanumeric, with key positions at 2, 5, 8, and 9 always alphabetic.

The transition period for the SSNRI will begin April 2018 and end December 31, 2019. CMS will begin mailing beneficiaries their new cards in April 2018. Healthcare providers who submit or receive transactions containing the HICN must modify their processes and systems to be ready to submit or change the MBI by April 1, 2018. With some exceptions, HICNs will no longer be used after January 2020.

In order to educate the healthcare industry on the Social Security Number Removal Initiative (SSNRI), CMS has provided certain instructions on Provider Open Door Forums. For physician practices to get ready for the change, CMS recommends to –

  • Attend CMS’ quarterly calls that provide updates and ongoing information about the Social Security Number Removal Initiative.
  • Verify patient’s address and confirm with the patient that it matches the address Medicare has on file.
  • Make sure that the claims processing system of their medical billing and coding companies can accept the 11-digit alphanumeric MBI.
  • Teach patients about the new Medicare cards.

Providers should remember that beginning October 2018 through the end of the transition period, when a valid and active HICN is submitted on Medicare fee-for-service claims, both the HICN and MBI will be returned on remittance advice.

CMS has also confirmed that the MBI won’t change Medicare benefits. People with Medicare may start using their new Medicare cards and MBIs as soon as they get them.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

More from This Author