Medicare Card Changes: What You Need to Know

Medicare Card Changes are coming soon. By April 2019, your card will be replaced with one that no longer shows your Social Security number.

The Centers for Medicare & Medicaid Services is no different. Realizing its use of the social security number as a member identifier could potentially put its more than 60 million enrollees at risk, CMS decided to update its patient identifiers to a more secure ID number to protect its customers and the medical providers who care for them.

Medicare Card changes

Recent high-level security breaches in the U.S. Voter Database, National Archives, and the Office of Personnel Management left more than 250 million Americans at risk of compromised data and identity theft. As hackers and identity thieves become more resourceful security can become more vulnerable, so government agencies are taking extraordinary precautions to protect our medical, financial, and personally identifiable information (PII) from those who would seek to compromise it.

Getting to Know the New Medicare Beneficiary Identifier (MBI)

By April 2019, all SSN-based Health Insurance Claim Numbers (HICN) will have been removed from Medicare cards and replaced by a new Medicare Beneficiary Identifier(MBI) that uses random numbers as the personal identifier. These precautions are all part of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, and will be used for transactions like billing, eligibility, and claim status.

Medical and PII (social security numbers, birthdates, etc.) data are especially attractive to identity thieves, to include those who would use a patient’s card to take advantage of Medicare benefits. By replacing the SSN-based HICN with the MBI,

CMS will not only ensures that private health care and financial information will be protected, but also federal healthcare benefits and service payments are safe.

Transition Timeline

The roll-out of new cards began April 2018, with CMS phasing them in by geographical region. On December 31, 2019, the roll-out will have been complete. On January 1, 2020, all Medicare users should have their new cards in hand.

During the transition period between April 1, 2018 and December 31, 2019, CMS will monitor the use of HICNs and MBIs to see how many beneficiaries will be ready to use only MBIs by January 2020. They will also actively monitor the transition and adjustment to the new MBIs to ensure their wide-spread adoption, so Medicare operations aren’t interrupted.

What does this mean for medical practices?

According to CMS, your office should be preparing now for the transition, even if your patients have not yet received their new cards. Proactive measures your office can take include:

  • Examining your current practice management systems and business processes to determine what changes you need to make to use the new MBIs. If changes needs to be done, do them now as your patients might already have received their new cards.
  • Practices that use third-party vendors or independent contractors to bill Medicare should be sure to contact them to find out about their MBI practice management system changes to ensure everyone is on the same page.
  • If you are part of a large practice, provider network, or partnership, you might want to find out how your colleagues and associates are handling the transition from HICNs to MBIs so you can coordinate your systems, if necessary.
  • You may also want to consider automatically accepting the new MBI from the remittance advice (835) transaction; and identifying patients who qualify for Medicare under the Railroad Retirement Board (RRB).
Helping your patients understand the transition

It’s important that your patients and office staff understand that the MBI will have no effect on benefits or quality of care. Patient security and provider protection are goals that the HCIN cards could find hard to fulfill. In fact, the MBIs actually decrease your patients’ vulnerability to become victims of waste, fraud, theft, and abuse.

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