In addition to creating the MIPS quality payment program, the Medicare Access and CHIP Reauthorization Act (MACRA) requires the Centers for Medicare and Medicaid Services (CMS) to remove Social Security numbers from all Medicare cards by April 2019. In place of the Health Insurance Claim Number (HICN) which uses the client's SSN, CMS will issue new Medicare cards that include a new Medicare Beneficiary Identifier (MBI). By avoiding the use of SSN-based identifiers, CMS hopes to fight identity theft of Medicare beneficiaries.
What does this mean for my clients?
Your clients can expect to receive new Medicare cards with their new MBIs beginning in April 2018. The Medicare Beneficiary Identifier will be 11 characters in length and use only numbers and capital letters. This identifier is completely random without any hidden or special meaning, allowing the identifiers to be less susceptible to theft or fraud while still being unique for each individual enrolled in Medicare.
What does this mean for me as a Medicare provider?
When Medicare beneficiaries begin receiving their new Medicare cards in April 2018, CMS will offer a transition period where providers can use either a client's HICN or new MBI when submitting Medicare claims. Starting in October 2018, the electronic remittance advice (ERAs) you receive will include the new identifier for the client. You have until January 1, 2020 before you are required to use only the new identifier on all Medicare claims.
As of November 1, CMS is providing additional information that is available to order. These educational materials are designed to help you understand the transition process and provide more information about the new identifiers.
How does this change affect TherapyNotes?
While our team is planning for the change, users will not experience any major changes to claims or ERAs in TherapyNotes. Our integrated billing features will accept both the current HICNs and the new MBIs throughout the transition period. Once you're ready to use a client's new MBI, simply enter the MBI in place of the client's previous HICN in their chart.
We will continue to provide you with more information to help you talk with your clients about the changes.
Sources: Centers for Medicare and Medicaid Services, New Medicare cards overview; Centers for Medicare and Medicaid Services, Understanding the Medicare Beneficiary Identifier (MBI) format; Centers for Medicare and Medicaid Services, New Medicare card Open Door Forum for providers (6/8/17)* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.