by Rebecca Ingalls, Reimbursement Supervisor, WellSky Revenue Cycle Management
Due to the increase in fraud and identity theft, especially crimes against vulnerable senior citizens, CMS is already underway with its effort to issue new ID cards for all Medicare beneficiaries. Previous Medicare ID cards included patients’ social security numbers, which raised concerns about the safety and protection of patient information.
Starting now and continuing through April 2019, CMS is mailing new cards with an updated Medicare beneficiary identifier (MBI) number instead of the traditional health insurance claim number (HICN) that contained the social security number. As of April 2018, patients in the following states received new cards: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia, Alaska, American Samoa, California, Guam, Hawaii, Northern Mariana Islands, and Oregon. Patients in the remaining state will receive their cards over the coming months.
What does this mean for your business as a provider? As you process new referrals or refill orders, it is important for your staff to ask patients if they received their new Medicare ID card, and if so, update your current software system with the new number. Depending on your software system, you may be able to create “tasks” or “to-do” items that will prompt the staff to ask for the new number and enter it in the system. CMS has a transition period from April 1, 2018 through December 31, 2019 during which you can use either the HICN or the new MBI number in fields where you have traditionally used the HICN. It is important not to submit both numbers on the same transaction. Use either one, but not both.
In an effort to make it easier for providers to utilize the new MBI numbers, you can use your Medicare administrative contractor’s (MAC’s) secure portal to look up these new patient numbers beginning in June 2018. To find MBIs in the portal, you will need your Medicare patient’s first and last name, date of birth, and social security number.
On January 1, 2020, you must provide MBIs for all transactions – even for dates of services prior to this date – with the exception of fee-for-service appeals, claim status query, and span-date claims.
WellSky can help
To ensure accurate billing based on complete patient information, it is important for your business to collect new MBI numbers from patients over the coming months and to update them in your software system. WellSky Revenue Cycle Services (formerly Mediware Reimbursement Services) can provide assistance to ensure your business is billing correctly and maximizing your reimbursement potential. Find out how our team of more than 60 billing experts can assist you with billing consulting, audit analysis, collection projects, and complete outsourcing so you can focus on providing great service to your patients!