Anesthesia Coding Alert

The countdown has begun for full implementation by January 2020.

The Centers for Medicare and Medicaid Services (CMS) began rolling out significant changes to their beneficiary cards in April 2018, but you might just be starting to see the updates in your practice. Read on for all you need to know about the changes and how to incorporate them in your office.

The changes stem in part from widespread Medicare benefit fraud and are intended to protect patients’ privacy and the security of their data. The new cards will not include patients’ Social Security number (SSN) or the Health Insurance Claim Number (HICN). Instead, the new cards will feature the Medicare Beneficiary Identifier (MBI).

“We’re taking this step to protect our seniors from fraudulent use of Social Security numbers, which can lead to identity theft and illegal use of Medicare benefits,” said Seema Verma, CMS Administrator, in a press release announcing the initiative.

Important: CMS wants the implementation to be complete by January 2020.

Here’s What’s Different

The MBI will be 11 characters in length and comprised of randomly generated numbers and uppercase letters, said Jennifer Mangan, who works at National Government Services (NGS), in a recent webinar. The new MBI will be applicable for traditional beneficiaries as well as railroad beneficiaries. Railroad Retirement Board (RRB) beneficiaries will receive a new MBI card that will specifically state their status as a railroad beneficiary and retiree.

CMS will use the numbers 0-9 and letters from A to Z in the MBIs, according to a CMS fact sheet. An exception to this rule is that the letters S, L, O, I, B, and Z will not be included. A MBI might look like this: 1EG4-TE5-MK73, according to CMS.

Take note:  Although dashes appear on the new cards, they are not considered part of the MBI and should not be entered into computer systems or used in file formats, per CMS advice.

Caution: Don’t forget that the MBI is considered personally identifiable confidential information, just like a patient’s HICN, so you should treat it as such. The protection of patients’ privacy, safety, and security is what initiated the Medicare card revision.

Unsurprisingly, fraudsters are already intent on hacking into the new system. “Reports suggest scammers are simply retooling their efforts with more creative ways to extract personal financial information from victims, oftentimes posing as a Medicare representative to do so,” warned Ettinger Law Firm in its “New York Elder Law Attorney Blog” in analysis on the subject.

MBIs Rolling Out Now

The new cards with MBIs began mailing in April 2018. Seven “waves” of distribution were planned, ending in June, according to the “New Medicare Card Mailing Strategy” report.

Be aware: Patients who live together, like spouses, may not receive cards at the exact same time, Mangan says. Beneficiaries can find their specific card mailing range through their mymedicare.gov personal accounts.

Important: “At no time will our customer service reps be able to release the MBI number over phone,” Mangan says. Beneficiaries can look up their own MBIs via a tool in the NGSConnex patient portal beginning in April 2018. Providers will be able to look up MBIs via NGSConnex beginning in June 2018.

Help Patients Through the Transition

Patients need to make sure the Social Security Administration has their current addresses. Stay connected with patients through this transition, and you can even remind them to call the Social Security Administration to update their addresses, Mangan says.

Go ahead and incorporate information on the new cards into your office “décor.” CMS has created a poster that you can hang in your office; you can find a link to the poster at the end of this article. When confirming appointments by phone or email, add a reminder that patients who have received their new cards should bring them to their appointment.

Patients may use their new cards as soon as they start receiving them in the mail, said Jean-Pierre Dalhouse, education outreach representative for Medicare Administrative Contractor (MAC) Noridian Healthcare Solutions in Fargo, North Dakota, in a recent webinar.

Prepare Accordingly

As the rollout begins, providers are responsible for ensuring that their systems are ready to accommodate MBI cards and can still perform all necessary communications, such as transactions, billing, claim status, and eligibility status, with their respective MAC contact centers, CMS says.

You’ll also want to make sure your billing system is ready to do all of the following immediately, according to MBI guidance via CMS:

• Recognize and accept the new MBI.
• Revise your practice protocols for Medicare Railroad Retirement Board (RRB) patients because they won't be distinguished by their card numbers anymore.
• Accept automatically the new MBI from the Remittance Advice (835) transaction.

Stay in communication with your patients, but also alert any software vendors and business partners, CMS suggests.

"There will be a transition period when you can use either the HICN or the MBI to exchange data and information with us,” notes CMS in its MBI fact sheet. “The transition period will start April 1, 2018, and run through December 31, 2019.”

The agency plans on monitoring Medicare provider efforts throughout this timeline, CMS says, in its Open Door Forum materials. This way, “Medicare operations aren’t interrupted and that everyone is ready to use only MBIs by January 2020.”

Top tip:  Crossover information will remain the same during the transition period when submitted through with the Health Insurance Claim Number (HICN). It will then be on the remittance in the corrected field and forwarded on for crossover, Mangan says.

Resources: Find the CMS fact sheet on the new MBIs by visiting www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TransitiontoNewMedicareNumbersandCards-909365.pdf.

To access various links and forms related to Medicare card changes, visit www.cms.gov/Medicare/New-Medicare-Card/index.html.

Find a printable English version of the MBI reminder poster here: https://www.cms.gov/Medicare/New-Medicare-Card/Partners-and-Employers/New-Medicare-Card-Poster.pdf and a Spanish version here: https://www.cms.gov/Medicare/New-Medicare-Card/Partners-and-Employers/NMC-Poster-Spanish.pdf.