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Key Differences: New Medicare ID Card

In April of 2018 and continuing for one year, the Centers for Medicare & Medicaid Services (CMS) will launch new Medicare cards. Called Medicare Beneficiary Identifiers (MBIs), these new numbers will replace the current health insurance claim numbers (HICN) that are social security numbers. The idea is to help prevent Medicare fraud and help beneficiaries avoid identity theft.

While the transition to MBIs will continue through December 2019, ensure the necessary workflow and technology system are updated now to prepare and avoid payment delays before the January 1, 2020 deadline.

Key Differences on New Card  

Some differences in the new cards include:

  • Uppercase letters and numbers
  • The letters B, I, L, O, S and Z will not be used to avoid confusing letters with numbers
  • Positions 2, 5, 8, and 9 will always be letters
  • No embedded logic
  • Each beneficiary will be assigned a unique identifier

Are You Prepared?  

Confirm that technology system changes do the following (as recommended by the AMA):

  • Store both the HICN and MBI (no overwriting) because you'll need the HICN for other purposes, such as audits, retrospective adjustments, appeals, and collections.
  • Accept and store a beneficiary's MBI in the electronic remittance advice for claims submitted with HICNs.
  • Prompt staff to ask patients for the new Medicare card when an eligibility response includes a message indicating that CMS has mailed the beneficiary a new card.
  • Register for a Medicare Administrative Contractor (MAC) Portal account to utilize the secure look-up tool that will launch June 2018. The tool will provide MBI information and will be useful when the patient does not have the card with him/her.   

There are real concerns that the packages the new card is mailed in will be discarded as junk mail. Start the conversation now with patients about the new card to prepare patients and ensure they bring the new card to the practice as soon as it's received. The more patient education, the better and your bottom line will thank you. 

Success Stories


Average bill age when our office received: 180 days plus BALANCE: $ 1,233.00 PROBLEM: Claim denied needing primary EOB. SOLUTION: Claim billed to supplemental policy instead of MMAI policy which was effective for service date.
Average bill age when our office received: 180 days plus BALANCE: $ 2,176.00 PROBLEM: Claim denied because of no insurance coverage for service date. SOLUTION: Claim was filed to incorrect claims address.
Average bill age when our office received: 180 days plus BALANCE: $ 1,013.50 PROBLEM: Claim denied because of insurance ID mismatch. SOLUTION: Claim filed to traditional plan vs. community care.
Average bill age when our office received: 180 days plus BALANCE: $ 1,203.00 PROBLEM: Patient disputed charge/balance owed, comparing it to a similar past bill. SOLUTION: Explained itemized charges and balance owed because of deductible. Patient stated first time someone took the time to explain and set up a payment plan.
Average bill age when our office received: 180 days plus BALANCE: $ 1,007.50 PROBLEM: Denied by hospice as non-eligible benefit and Medicare as ID name mismatch. SOLUTION: Verified/corrected Medicare ID, name and date; confirmed hospice non-eligibility.
Average bill age when our office received: 180 days plus BALANCE: $ 1,305.00 PROBLEM: Denied no pre-authorization for service. SOLUTION: 3-way call with patient and insurance. No ER report on file when claim originally submitted. ER report since received.
Average bill age when our office received: 180 days plus BALANCE: $ 1,001.50 PROBLEM: Denied with "misrouted" and "claim not covered by payor". SOLUTION: 3-way call with patient and insurance. Claim was related to mental health so should have been filed through carve out policy.
Average bill age when our office received: 180 days plus BALANCE: $ 1,755.00 PROBLEM: No response from insurance after requested records submitted. Patient stated insurance paid. SOLUTION: Billing office did not receive/post insurance payment. Called insurance and records received but claims representative had not released for processing.
Average bill age when our office received: 180 days plus BALANCE: $ 4,540.50 PROBLEM: Multiple bills, same service dates as claims already paid. Denied due to no pre-authorization for service. SOLUTION: Call to insurance who verified no pre-authorization requirement. Two claims not found. To prevent duplicate denial upon resubmission, account rep notated resubmission for return transportation trip. Proof of timely filing submitted with claims.
Average bill age when our office received: 180 days plus BALANCE: $ 1,180.00 PROBLEM: Denied due to no pre-authorization for service. SOLUTION: 3-way call with patient and insurance. Claim should have been sent directly to IPA vs. umbrella insurance location.
Average bill age when our office received: 180 days plus BALANCE: $ 1,117.00 PROBLEM: Unpaid due to incomplete demographic information. SOLUTION: Contacted pick up and drop off locations. Sent release to obtain information and patient’s name misspelled.
Average bill age when our office received: 180 days plus BALANCE: $ 1,605.00 PROBLEM: Denied due to medical necessity. SOLUTION: 3-way call with patient and insurance. Spoke with multiple reps and received different answers including claim not found. Claim was found with no response from medical board. Patient had to submit medical records.
Average bill age when our office received: 180 days plus BALANCE: $ 1,007.50 PROBLEM: Denied multiple times as duplicate. SOLUTION: Located claim number ID, amount paid and date paid. Claim had already been paid in full but not posted.
Average bill age when our office received: 180 days plus BALANCE: $ 1,650.00 PROBLEM: No insurance on file. SOLUTION: Pick up location was state prison. Located inmate ID and could be billed to prison insurance as still within timely filing limits.
Average bill age when our office received: 180 days plus BALANCE: $ 2,295.50 PROBLEM: Denied as “forwarded to another entity for processing”. SOLUTION: Called insurance for medical group processing information. They did not have claim on file. Resubmitted with proof of timely filing.

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