By Sean McSweeney bio
In a press release on May 30, 2017, the Centers for Medicare & Medicaid Services (CMS) commented regarding their fraud prevention initiative program and their planned changes regarding Medicare beneficiary cards.
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires this change.
During the period of time between April 2018 to April 2019, Medicare will be issuing new Medicare beneficiary cards to all Medicare recipients.
The new Medicare Beneficiary Identifier (MBI) will replace the current SSN-based member cards.
Click here to see the few minor exceptions to this rule.
What can I do now to prepare for this change?
As a laboratory, it is recommended to post a notice in your front office, letting your Medicare patients know about this change.
You can get Medicare approved bulletins here.
After the transitional period, if the billing office doesn’t have the correct MBI number, Medicare will not process claims.
Taking the time now to ask your patients if they have received a new Medicare card at the time of their appointment will assist your office with this change.
This action will prove beneficial when Medicare payments and claims are not delayed.
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What is Medicare’s role in this process?
Under this new system, Medicare will assign a new MBI number to each beneficiary and mail a new Medicare card to them.
During their transitional period, they will also monitor each geographical area to identify if medical practices have started to receive these new MBI numbers.
In addition to this, they will issue the new cards to the clients themselves.
Why are these new cards important?
The biggest reason Medicare is incorporating this is to fight medical identity fraud and theft for individuals with Medicare benefits.
These new cards expel the possibility that client’s SSN can be taken by would-be defrauders, which will protect the insured’s identity.
How does this affect your lab?
After this change, the new MBI will be required for all Medicare transactions, such as claims billing, claims status, and eligibility status.
Medicare plans to have a transition period (April 1, 2018 to Dec. 31, 2019) where you can use either ID number.
Seeing as MCR issues the card, your lab’s main, day-to-day responsibility is to ensure the new card is scanned into the Laboratory Information System.
This will help minimize denials for this technicality. Train your billing team, too, to expect this new requirement as soon as possible.
Starting Jan. 1, 2020, all inquiries to Medicare whether for claims, eligibility, or payment status, will require the new MBI number.
In October 2018, if the patient has an MBI number assigned, Medicare will return the remittance advice with the new MBI number.
Front office staff should update their records to reflect these new ID numbers if they differ.