HICN transitions to MBI . How should Therapists prepare?

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Healthcare organizations continue to ramp up efforts to enhance online security by reducing vulnerabilities associated with the use of SSNs. In the spirit of strengthening security around patient data, CMS has issued Medicare Beneficiary Identifier (MBI) on a patient’s new Medicare card.

All healthcare providers, including physicians, therapists, counselors, and other mental health professionals who bill Medicare for insurance will be impacted by this. The transition period will end December 31, 2019 and MBIs must be used starting January 1, 2020. Until then, however, providers can continue to use their issued ID number or the MBI.

Prepare. Prepare. Prepare

Your systems and business processes should be ready to accept MBIs. All of the business transactions involving billing, claims, and beneficiary eligibility statuses, or any other interactions with Medicare makes it mandatory to be able to accept MBIs by end of this year. Have your staff coordinate activities around this:

To Do List

  1. Communicate with existing clients
  • For existing clients, it would be best to send out communication to update their MBIs in the system.
  • CMS has also launched a wide-scale communication to educate Medicare beneficiaries about this. Medicare and You Handbook has additional information on this.
  • Use the Medicare published mailing schedule to anticipate when clients will have a new card with the MBI.
  • Beneficiaries can also log in to https://www.mymedicare.gov/ to obtain information on their MBI.

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2. During Client Intake:

  • Ask your client if they have been issued a new Medicare card yet.
  • Ask client for their new MBI on their new card.
  • Help clients verify their address on file. If it does not match the address on the eligibility response, they will not have received a new card. In that case, they should contact the Social Security Administration (SSA) to update their information.
  • If they don’t have MBI yet, give them Get Your Medicare Card flyer
  • Use Medicare Contractor Look up tool.
  • Check remittance advice for MBI. CMS returns MBI on remittance advice for every claim with a valid HICN

3. Update Electronic Remittance Advice (ERA):

  • Update Medicare beneficiary numbers in your systems.
  • MBI will also be returned on every ERA with claims submitted with a valid HICN number

MBIs automatically.

4. Final verdict on MBI : Will Your Claims be Rejected?

Per CMS’s MBI Information Bulletin dated July 23rd, 2019:

“Protect your patients’ identities by using the Medicare Beneficiary Identifier (MBI) now. Starting January 1, 2020, you must use the Medicare Beneficiary Identifier (MBI). We will reject claims you submit with the Health Insurance Claim Number (HICN), with a few exceptions, and reject all eligibility transactions”.


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