Medicare is now mailing new ID numbers to beneficiaries. Last week, we posted a short guide to updating billing software with the new Medicare Beneficiary Identifiers (MBI) using payment remittances. Today, we are passing along six tips to familiarize customer service representatives and medical billers with the new cards, ID numbers, and transition process.
1. Just like with the old HICN, the hyphens in the MBI are for illustration only.
Do not include hyphens or spaces when filing claims or performing eligibility checks.
2. The MBI uses numbers 0-9 and all uppercase letters except for S, L, O, B, I, and Z.
No Medicare card will ever use these six excluded letters. CMS omitted them to avoid confusion (e.g. between “0” and “O”, “5” and “S”, “8” and “B”, etc.).
3. The card and identification number are not permanent.
CMS can change an individual’s MBI if, for example, an existing identifier is compromised. Beneficiaries and their authorized representatives can also request a new MBI.
Suppliers will receive the response “Invalid Member ID” in real-time eligibility inquiries when using expired or deactivated MBIs. Fortunately, suppliers can use the Noridian Medicare Portal (NMP) and the myCGS portals to search for MBIs. The lookup will only return an MBI if CMS has officially mailed the new card to the recipient. To secure the MBI, the supplier must enter a correct HICN, first name, last name, and date of birth. If available, the tool returns a cross-walked MBI assigned to the beneficiary.
4. Some of the new cards have a square QR code, but there is no application for supplier use.
The mailing contractor uses the machine-readable codes for delivery purposes. Unfortunately, suppliers cannot use them for checking eligibility or any other purposes. Railroad Retirement Board (RRB) Medicare cards will have the QR code on the front of the card, while traditional Medicare cards have the QR code on the back. Regardless of presence or placement, these are official Medicare cards.
5. Beneficiaries enrolled in Medicare Advantage and Prescription Drug plans will also get new Medicare cards, but the new card does not change the beneficiary’s enrollment status.
For DME claim filing purposes, suppliers must utilize the distinct policy numbers issued by the Advantage and Drug plans, not the MBI on the new Medicare card.
6. The MACs have helpful tools to assist with the transition.
Noridian created a helpful MBI dedicated landing page with relevant details on the MBI transition. The site details information about the transition period, MBI format, preparation and implementation.
CGS created a telephone MBI converter tool to help suppliers in Jurisdictions B and C enter the new IDs during an IVR inquiry. Noridian provides a similar IVR Conversion Tool on their website for suppliers located in Jurisdictions A and D. Simply enter the 11-digit MBI into the box and click “Convert my MBI”. The system will return the proper keypad entries to convey the identifier to the IVR.
1. Just like with the old HICN, the hyphens in the MBI are for illustration only.
Do not include hyphens or spaces when filing claims or performing eligibility checks.
2. The MBI uses numbers 0-9 and all uppercase letters except for S, L, O, B, I, and Z.
No Medicare card will ever use these six excluded letters. CMS omitted them to avoid confusion (e.g. between “0” and “O”, “5” and “S”, “8” and “B”, etc.).
3. The card and identification number are not permanent.
CMS can change an individual’s MBI if, for example, an existing identifier is compromised. Beneficiaries and their authorized representatives can also request a new MBI.
Suppliers will receive the response “Invalid Member ID” in real-time eligibility inquiries when using expired or deactivated MBIs. Fortunately, suppliers can use the Noridian Medicare Portal (NMP) and the myCGS portals to search for MBIs. The lookup will only return an MBI if CMS has officially mailed the new card to the recipient. To secure the MBI, the supplier must enter a correct HICN, first name, last name, and date of birth. If available, the tool returns a cross-walked MBI assigned to the beneficiary.
4. Some of the new cards have a square QR code, but there is no application for supplier use.
The mailing contractor uses the machine-readable codes for delivery purposes. Unfortunately, suppliers cannot use them for checking eligibility or any other purposes. Railroad Retirement Board (RRB) Medicare cards will have the QR code on the front of the card, while traditional Medicare cards have the QR code on the back. Regardless of presence or placement, these are official Medicare cards.
5. Beneficiaries enrolled in Medicare Advantage and Prescription Drug plans will also get new Medicare cards, but the new card does not change the beneficiary’s enrollment status.
For DME claim filing purposes, suppliers must utilize the distinct policy numbers issued by the Advantage and Drug plans, not the MBI on the new Medicare card.
6. The MACs have helpful tools to assist with the transition.
Noridian created a helpful MBI dedicated landing page with relevant details on the MBI transition. The site details information about the transition period, MBI format, preparation and implementation.
CGS created a telephone MBI converter tool to help suppliers in Jurisdictions B and C enter the new IDs during an IVR inquiry. Noridian provides a similar IVR Conversion Tool on their website for suppliers located in Jurisdictions A and D. Simply enter the 11-digit MBI into the box and click “Convert my MBI”. The system will return the proper keypad entries to convey the identifier to the IVR.
Note the conversion tool does not validate the MBI or confirm eligibility for Medicare. It simply converts the identifier for easier telephone keypad entry. Some suppliers convert the MBI as a part of the intake process and screen print the converted characters to the patient’s file for future calls.
SOURCE LINKS
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNmattersArticles/downloads/SE18006.pdf
https://www.cms.gov/Medicare/New-Medicare-Card/index.html
SOURCE LINKS
https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNmattersArticles/downloads/SE18006.pdf
https://www.cms.gov/Medicare/New-Medicare-Card/index.html
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