Medicare is rolling out new cards and MBI numbers, and Patient Access professionals must be prepared to answer questions
Check out the NAHAM webinar 'Are You Ready for the New Medicare Cards' for tips and tricks for your organization.
The Centers for Medicare and Medicaid Services (CMS) began issuing new Medicare cards in April 2018. Medicare beneficiaries will receive their cards in the mail between April 1, 2018 and April 1, 2019. The new Medicare cards are necessary because the 2015 law, the Medicare Access and CHIP Reauthorization Act, requires CMS to remove Social Security numbers from Medicare cards by April 2019. The move is seen as a way to guard against identity theft; specifically, it is seen as a way to better protect private healthcare and financial information as well as federal healthcare benefits and service payments.
Replacing the Social Security number (the SSN-based Health Insurance Claim Number, or HICN) will be a new Medicare Beneficiary Identifier (MBI). Each beneficiary will be assigned a unique MBI, and it will appear on the new Medicare cards for existing beneficiaries and all new enrollees going forward.
A transition period began April 1, 2018 and will run through December 31, 2019; during this period, providers may use either the SSN-based HICN or the new MBI for purposes of data exchange. Starting January 1, 2020, providers will be required to submit claims using MBIs, no matter the date of service. CMS has developed a secure look-up tool for providers to find the new number at the point-of-service, and when a provider checks a beneficiary’s eligibility, the CMS HIPPA Eligibility Transaction System (HETS) will return a message indicating if CMS has mailed a new card to the beneficiary. CMS has also issued some detailed information on appeals, adjustments and span-date claims.
The new MBI will clearly look different from the Social Security number and two-character Beneficiary Identification Code on the old cards. The MBI will be 11 characters in length, solely made up of numbers and uppercase letters (no special characters). Each MBI is unique and randomly generated, and the characters and sequence are “non-intelligent,” meaning they don’t have any hidden or special meaning. There is a sequence protocol in that certain positions of the 11-character MBI will only have numeric or alphabetic characters, and two positions may have either numbers or letters. Positions 2, 5, 8 and 9 will always be alphabetic. See the CMS webpage: Understanding the Medicare Beneficiary Identifier (MBI) Format [insert link: https://www.cms.gov/Medicare/New-Medicare-Card/Understanding-the-MBI.pdf], for more information.
The new card will have the beneficiary name, the new Medicare Beneficiary Identifier, coverage and coverage dates. These element names will be in both English and Spanish. The gender and signature line found on the old Medicare card will not appear on the new card. All cards will be printed on white paper.
Once issued, beneficiaries and providers may begin using the new MBI immediately. For more information, see the CMS webpage: What do the new Medicare cards mean for partners and employers? [insert link: https://www.cms.gov/Medicare/New-Medicare-Card/Partners-and-Employers/Partners-and-employers.html]
Mailings will include the new card and a letter with instructions for the beneficiary. Distribution of cards will be random, so there is no relationship between mailing and geographic regions.
A September 2017 CMS survey found “extremely low awareness” of the planned changes among beneficiaries. When told of the changes, the survey found most see this as a positive change and had no major concerns. CMS is including education during its 2017 open enrollment and will be sending providers information on how they can help during the first quarter of 2018. CMS is also planning an aggressive social media campaign.
CMS advises providers to check with their solution vendors to make sure they have received instructions about the secure provider look-up tool, and that they are aware of all system changes. CMS also asks providers to display posters and place “tear-off” pads in offices and waiting rooms — all of which may be found and ordered online. Providers should also periodically check the Medicare Learning Network [insert link: https://www.cms.gov/medicare/new-medicare-card/nmc-home.html] for more information.
Providers will be involved in educating patients, and CMS provides a number of resources to use when talking to patients about their new Medicare cards. Here are some of the points CMS emphasizes in these materials to tell patients:
1. Right now patients should make sure their mailing addresses are up to date with the Social Security Administration. CMS will use that address to send a new Medicare card. They can check and update online through your “my Social Security” account [insert link: https://www.ssa.gov/myaccount/] or by phone 1-800-772-1213 (TTY: 1-800-325-0778).
2. Patients may not get the new Medicare card right away. Mailing out new cards to all beneficiaries will take time. They will only need to call Medicare if they don’t receive their card by April 2019.
3. Patients should be wary of anyone who contacts them about their new Medicare cards. Medicare will never ask someone to give them personal or private information for a new card or number. CMS is planning a “Guard Your Card” campaign starting in late summer of 2018.
4. Even though they are getting a new Medicare card and number, a patient’s Social Security number remains the same. They just won’t be using it relative to their Medicare benefits.
5. Once they receive a new Medicare card, patients should check the name and other information to make sure it is correct. The new card will not change their current coverage or benefits. If everything is in order, they should destroy the old card and start using their new card.
6. Patients must remember to bring their new Medicare card. Doctors and other healthcare providers will ask for it when they need care. If they forget their new card, doctors or other healthcare providers may be able to look it up online.
7. Patients should guard their new card and new identification number (the MBI) just as they did their old card and Social Security number. They should only give their card and MBI to doctors, pharmacists and other healthcare providers, their insurers or people they trust to work with Medicare on their behalf.
8. Their new card will be paper. It will be easier for providers to use and copy and they can print your own replacement card if need be.
Is Your Address Up to Date?
This should become the most common question you ask Medicare beneficiaries. Not the first thing you’d think of when talking to patients about the new Medicare cards that will start appearing this spring, but providers will play an important role in educating patients about the new cards and the new Medicare Beneficiary Identifiers. One important thing for the Medicare beneficiary to do is to make sure their mailing address is up-to-date with the Social Security Administration because CMS will use the address they have on file with Social Security; new cards started mailing out on April 1, 2018 and will continue through April 1, 2019.
Be Vigilant Against Identity Theft
Beneficiaries should know not to share their new Medicare number with anyone other than their healthcare providers, their insurers or trusted healthcare advocates with Medicare. Medicare will never ask someone to give them personal or private information just so they can get their new card or number. Don’t fall for phone scams!