Podiatry Coding & Billing Alert

Hint: You must prepare your practice's systems to accept new MBIs by April 2018.

When it comes to seeing Medicare patients at your podiatry practice, you should mark down April 2018 as an important month on your calendar. This is when CMS will start mailing out the new Medicare cards to patients. These new cards will contain the new Medicare Beneficiary Identifier (MBI).

Patients may use their new cards as soon as they start receiving them in the mail, said Jean-Pierre Dalhouse,  education outreach representativeat Noridian Healthcare Solutions in Fargo, North Dakota, in a recent webinar.

Read on to learn why the Medicare cards are changing and everything you need to be aware of as you prepare your practice for this change.

Identify Reasoning Behind the Change

Currently, patients' Medicare cards contain their Social Security numbers (SSNs) as the primary identifiers. The SSNs also work as the Health Insurance Claim Number (HICN).

However, as a requirement of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, CMS must remove all SSNs from Medicare cards by April 2019. The updated cards will include a brand-new number - the 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 last year that announced the initiative.

Delve Into MBI for Clearer Understanding

Each unique MBI will consist of 11 randomly generated alphanumeric characters that will be "non-intelligent." In other words, they won't have any special or hidden meaning, Dalhouse said.

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.

If you're wondering what a MBI could look like, CMS offers this example for your reference: 1EG4-TE5-MK73

You should notice that although dashes do appear on the new cards, these dashes are not considered part of the MBI and should not be entered into computer systems or used in file formats, according to CMS.

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.

Prepare Your Practice for New MBIs

All Medicare providers must make sure their systems and business processes are ready to accept the MBI by April 2018 for "transactions, such as billing, claim status, eligibility status and interactions," with MAC contact centers, CMS says.

It's of upmost importance that Medicare providers are prepared for patients who are new to Medicare in April 2018 and later because they will only receive a card with the MBI, according to CMS.

One way to prepare is to alert your patients, software vendors, and business partners of the Medicare card and number overhaul, CMS suggests. And, you should verify your Medicare patients' addresses as accurate so they will be certain to receive their new cards.

You'll also want to make sure your billing system is ready to do all of the following on day one, 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.
• Automatically accept the new MBI from the remittance advice (835) transaction.

Transition period: Despite the need for a complete overhaul of your billing system to accept the new identifier, there is some good news: CMS has established a transition period where Medicare providers can use the HICN or MBI to exchange data and information. This period starts on April 1, 2018 and will continue through December 31, 2019.

Resources: To utilize the CMS fact sheet on the new MBIs, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/TransitiontoNewMedicareNumbersandCards-909365.pdf. To access various links and forums related to Medicare card changes, visit www.cms.gov/Medicare/New-Medicare-Card/index.html.