9 steps to welcoming the new Medicare card in your practice

You know all about the welcome to Medicare preventive visit. Now your practice needs to be ready to say “welcome” to the new Medicare card.

After almost three years of preparation, the Centers for Medicare & Medicaid Services (CMS) will begin releasing new cards designed to protect the personal information of Medicare beneficiaries. The change will significantly affect practice workflows, but following this advice from the AMA will help your practice avoid payment delays and ease the transition for your senior patients.

New Medicare cards designed to thwart identity theft will be mailed out to all 60 million active beneficiaries over the next 12 months. The cards contain a new 11-character Medicare Beneficiary Identifier (MBI) that will replace the Social Security number-based Health Insurance Claim Number (HICN).  While both the MBI and HICN can be used on claims and other electronic transactions for active beneficiaries during the transition period that extends through Dec. 31, 2019, practices should start using the new MBIs right away.

“All providers, vendors, and other stakeholders must be ready to accept, receive, and transmit the new MBI  ... particularly for the new beneficiaries coming into the program,” Monica Kay, acting director of the CMS division of program management, said during an AMA-sponsored webinar.

Kay recommended practices start using MBIs as soon as they receive them from their patients or from CMS via remittance advice they receive after submitting a claim. Starting this June, physicians and their staff can also obtain patients’ MBIs via a look-up tool available through their practice’s Medicare Administrative Contractor’s (MAC’s) secure web portal. Region-specific MAC portal information can be found on the CMS website.

“We are strongly encouraging early adoption of the MBI before the transition period ends,” Kay said. “As soon as a patient comes to you and they have it, please start using it.”

Starting this month, newly enrolled Medicare beneficiaries will only receive cards with MBIs. Beginning Jan. 1, 2020 only MBIs will be accepted in Medicare transactions, though there will be limited exceptions for the use of HICNs, such as appeals and retrospective adjustments.

Here are nine steps your practice should take to ease the transition and avoid payment delays:

  • Educate practice staff about the rollout of the new Medicare cards with the new MBIs.
  • Contact practice-management system vendors about what system changes need to be made to accommodate the MBIs.
  • Alert your Medicare patients that they will be receiving new Medicare cards with their new MBIs.
  • Remind Medicare patients to confirm that the Social Security Administration has their correct address on file to ensure that they receive their new Medicare cards.
  • Tell Medicare patients to bring their new Medicare cards to their next appointment after they receive it.
  • Begin using the new MBI in Medicare transactions as soon as it is available for the patient.
  • Monitor eligibility responses for messages that indicate the patient was mailed a new Medicare card.
  • Starting Oct. 1, 2018, monitor remittance advices for messages that provide the patient’s MBI.
  • Sign up for the MBI look-up tool via your regional MAC portal.

Pointers for patients, staffers, vendors

Additional AMA and CMS materials designed to help practices transition to using the MBI are available on the AMA’s “Prepare for the New Medicare Card” webpage. It includes guidance to ensure practices’ business systems and IT vendors are MBI-ready, as well as promotional posters and fliers to help publicize and explain the change to patients.

For example, practice-management systems should be able to save and store both the old HICN and the new MBI. While only the MBI will be accepted on Medicare transactions after the end of the transition period, practices may need the HICN for appeals, adjustments or reporting functions.

Practice staff should be aware that the new cards use dashes to break up the characters used in a beneficiary’s MBI. These dashes are intended to make the MBI easier to read, but should not to be used or entered for transactions.

Practices can also help protect their Medicare patients from potential fraud. Explain that CMS will not call patients to ask for any personal information before sending the new card. Let your patients know that if they do get a call from someone claiming to be from Medicare who asks for their Social Security number or any other personal information, they should not share it under any circumstances.

The congressional mandate to remove Social Security numbers from Medicare cards by April 2019 was included in the Medicare Access and CHIP Reauthorization Act (MACRA). In the webinar, CMS’ Kay said the agency’s process for transitioning to the new Medicare card was designed in a manner that “doesn’t provoke fraudsters.”