Providers & office managers
What do the new Medicare cards mean for health care providers & office managers?
When you start using the new Medicare Beneficiary Identifiers (MBIs), you're helping to protect the identities of people with Medicare and keep them safer from identity theft.
Look at your practice management systems and business processes to determine what changes you need to make to use the new MBIs.
Make changes and test them now, since we're mailing out the new Medicare cards.
If you use vendors to bill Medicare, you should contact them to find out about their MBI practice management system changes.
You might also want to find out how other health care providers who also treat your patients are handling the transition from HICNs to MBIs so you can coordinate your systems, if necessary.
Even though we’ll stop using Social Security Numbers (SSNs) to identify Medicare beneficiaries, what won’t change is how your own Social Security Number is used for the Internal Revenue Service (IRS )and tax reasons, like on your W-9.
What should health care providers & office managers do to get ready for the new Medicare cards and MBIs?
To get ready to use the new MBIs, make and internally test changes to your practice management systems and business processes by April 2018 before we mail new Medicare cards. Your billing and office staff might have to coordinate their work to make sure your practice is ready. Also, if you use vendors to bill Medicare, contact them to find out about their MBI practice management system changes. It’s especially important that you’re ready for people who are new to Medicare in April 2018 and after because they’ll only get a card with the MBI.
You may want to consider:
- Automatically accepting the new MBI from the remittance advice (835) transaction.
- Identifying patients who qualify for Medicare under the Railroad Retirement Board (RRB).
If you don’t already have access to your Medicare Administrative Contractor's (MAC) provider portal, sign up so you can use the provider MBI look-up tool. Starting in June 2018, if your patients’ new Medicare cards have been mailed to them, you can use the MBI look-up tool to find their new MBIs. Your office/facility staff might want to coordinate with your billing/administrative staff, who may already have portal access.
You'll also want to attend our calls to get more information about this project; we’ll let you know about upcoming calls through Medicare Learning Network (MLN) Connects.
When should health care providers & office managers use MBIs?
Once patients get their new Medicare cards & MBIs
Use MBIs right away - as soon as your patients get their new cards. The effective date of the new cards is the date beneficiaries are eligible for Medicare.
We'll continue to accept the Health Insurance Claim Number (HICN) through the transition period. During the transition period, we’ll:
- Process claims you submit with either the HICN or the MBI. This will give you and your billing agencies the chance to change your systems if there are problems with claims you submitted using the MBI.
- Keep track of when claims are sent in and other transactions are done so we can gauge MBI usage.
Once we start mailing out new Medicare cards, people new to Medicare will only be assigned an MBI. Your systems must be ready to accept the MBI by April 2018.
All HICN-based claims have to be received by the January 1, 2020 - the cut-off date. After the transition period ends on January 1, 2020, with a few exceptions, you’ll need to use MBIs on your claims.
You can start using the MBIs even if the other health care providers and hospitals who also treat your patients haven’t.
Find tips for successfully using the MBI, what to do if an MBI changes, and more in our MLN Matters article, "New Medicare Beneficiary Identifier (MBI) Get It, Use It".
Where can health care providers & office managers get more information about the new Medicare cards?
- Find more details if you’re a Medicaid, supplemental insurer, or other private payer.
- Get our print-friendly MLN fact sheet.
- We’re holding Open Door Forums every quarter so we can get your feedback and hear how things are going. You can also get training materials from our past Open Door Forums.
- You can also check our new Medicare card Outreach & education page to get information for you and resources you can use when you talk to people with Medicare about the new Medicare cards.
- Read our frequently asked questions.
- Check back here often; we’ll be updating this webpage when we’ve got new information to share, including new policies and system requirements.
Where can health care providers & office managers get help with the new Medicare cards?
The Provider Ombudsman for the New Medicare Card is your resource to make sure we hear and understand any problems you’re having implementing the new Medicare cards. As the Provider Ombudsman, Dr. Eugene Freund will send you information about the new Medicare cards and work inside CMS to settle any implementation problems that come up. Contact the new Medicare card Ombudsman.
- Page last Modified: 08/30/2018 6:11 PM
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