Client Alert: Medicare Beneficiary Identifiers: The New, More Secure System for Medicare Beneficiaries

Starting January 1, 2020, all physicians, providers, and suppliers submitting claims to Medicare Administrative Contractors (MACs) for all services provided to Medicare beneficiaries, including Durable Medical Equipment, Home Health, and Hospice, must use Medicare Beneficiary Identifiers (MBIs) when submitting claims. Health Insurance Claim Numbers (HICNs), based on social security numbers, were replaced with randomly generated MBIs to provide better safety and security to Medicare beneficiaries. CMS recently finished mailing out new MBI cards to all beneficiaries.

Beginning January 1, 2020, providers and suppliers will no longer be able to submit claims with HICNs; instead, providers and suppliers will only be able to use HICNs for claim appeals and related forms, to check the status of a claim when the date of service was before January 1, 2020, or to submit certain claims for services that continued on or after January 1, 2020 if the start date of those services was prior to January 1, 2020.

In order to submit a claim, providers and suppliers will need to obtain MBIs for their Medicare patients. There are three ways providers and suppliers can obtain these MBIs:

  • Ask their Medicare Patients – When a patient comes for care, the provider or supplier can ask to see the patient’s new Medicare card. If the patient has not yet received their new card, the provider or supplier should provide them the “Get Your New Medicare Card” flyer. Additionally, Medicare patients can log onto gov to get their MBI.
  • Use Your MAC’s Secure MBI Look-up Tool – When a patient cannot or will not provide their new MBI, a provider or supplier can look it up. The provider or supplier will need to sign up for their MAC portal to use the look-up tool. In order to use the look-up tool, the provider or supplier will need to have the patient’s social security number.
  • Remittance Advice – When a provider or supplier submits a claim with a valid HICN through December 31, 2019, the patient’s MBI will be included in every piece of remittance advice returned in connection with these claims. A provider and supplier can copy the MBI down from this and use it for future claims.

MBIs are used exactly the same way as HICNs were when submitting claims. If a provider or supplier tries to submit a claim after January 1, 2020, for any services rendered after January 1, 2020, with a HICN, they will receive rejection codes if the claim was submitted electronically or paper notices of claim adjustment if they submitted a paper claim.

Should you, your practice, or your business have any questions about these changes and the new MBIs, please contact Peter Mellette, Nathan Mortier, Harrison Gibbs, Elizabeth Dahl Coleman, or Scott Daisley at Mellette PC.

This client advisory is for general educational purposes only. It is not intended to provide legal advice specific to any situation you may have. Individuals desiring legal advice should consult legal counsel for up-to-date and fact-specific advice.

Categories: Client Advisory