What did you say?
Currently, each traditional Medicare (MC) enrollee has an identification card with a Health Insurance Claim Numbers (HICN) (i.e. policy number). For the clear majority of MC beneficiaries, the HICN is the patient’s social security number (SSN) followed by the letter “A” (for beneficiary), with some exceptions, such as “B” for spouse of 65 years old and “C” for child or grandchild of a retiree.
The SSN-based HICN is being eliminated! The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires the Centers for Medicare and Medicaid Services (CMS) to remove Social Security Numbers (SSNs) from all MC cards by April 2019. A new MC Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new MC cards for MC transactions such as billing, eligibility status and claim status. You can find more details in the 5/30/17 press release and latest Open Door Forum slides (6/8/17).
The MBI will clearly be different than any HICN or Railroad Beneficiary Number, 11 characters in length, and made up only of numbers and uppercase letters (no special characters). Each MBI is unique, randomly generated, and the characters are “non-intelligent,” which means they don’t have any hidden or special meaning. An example of an MBI is 1AN0XA9MR84 – you can see it is random! More specifications on the MBI can be found by clicking here.
Why is CMS making these changes?
Let’s ask a different question—what do you think about your SSN being on an ID card given to multiple healthcare providers and insurance carriers, whom also have other personal health information (PHI)? Congress, the General Accountability Office, MC beneficiaries, providers, and many advocacy groups believe the SSN is not the best practice. The importance of privacy and security for patients, provider, and businesses as described in HIPAA law is on the forefront in the healthcare world; therefore, it has been recognized that including the SSN on ID cards is insecure and an idea of the past.
Removing the SSN will help protect the MC beneficiary and providers by fighting against medical identity theft and better protecting private health care and financial information, and federal health care benefit and service payments.
When is this happening?
Beginning in April 2018, CMS will begin mailing the new MC cards with the MBI to all people with MC.
There will be a transition period (April 1, 2018, to December 31, 2019) where providers can use either the HICN (old ID) or the MBI (new ID) to exchange data MC. CMS must remove the SSN from all MC cards by April 2019.
Starting January 1, 2020, only the MBI will be excepted by MC (with a few exceptions).
Who does this affect?
Traditional MC Beneficiaries
Benefits will not change, and beneficiaries should start using their new cards as soon as they are received beginning April 2018.
- Expect to see new MC cards with the MBI beginning April 2018—don’t forget to scan these new images into the practice management (PM) system and/or EMR.
- Be careful when entering the new ID—the IDs are completely random with multiple numbers and letters.
- In your PM system, end date the insurance record with the old HICN, then …
- Create a new insurance record with the new MBI and “new” effective date (the exact dates would depend on each individual patient’s claims and when the MBI is first presented).
- Start filing claims to MC with the MBI to ensure there are no PM system or payer errors.
- Note: MC is not offering end-to-end testing because providers can use either HICNs or MBIs to submit claims during the transition period. CMS will internally test systems that use MBI, including enhanced integration testing (EIT) for new or high-risk systems.