On Their Way: New Medicare Patient ID Numbers

Who carries their Social Security number in their wallet anymore? Answer: Medicare recipients, on their Medicare ID card. But that will change in April, when Medicare patients may begin coming to your office with new ID cards in hand. The Centers for Medicare & Medicaid Services (CMS) will send out the new cards in phases over several months.

The New Medicare Card project is part of the Medicare Access and CHIP Reauthorization Act (MACRA) and requires CMS to remove the Social Security number from Medicare cards out of concerns over identity theft. 

Medicare patients’ health insurance claim number (HICN), which is based on their Social Security number, will be replaced by randomly generated Medicare beneficiary identifiers (MBIs). 

Your systems will need to be able to accept the new MBI format in April, although you’ll be able to bill and file health care claims using a patient’s HICN during a 21-month transition period. Beginning in October, through the transition period, when you submit a claim using a patient's HICN, CMS will return both numbers — the HICN and the MBI — on every remittance advice, as shown in this example. For more information, visit CMS' provider page on the new Medicare card

In addition, based on feedback from TMA and others, CMS is developing a tool with which you’ll be able to look up patients’ new MBI at the point of service.

Note also that if you currently send Railroad Retirement Board (RRB) Medicare claims to the RRB specialty Medicare administrative contractor, Palmetto GBA, you’ll notice a change with the new cards:

  • You’ll no longer be able to distinguish people with Railroad Medicare by the number on the card. (RRB will continue to send cards with the RRB logo to people with Railroad Medicare.)
  • Palmetto will return a message on the eligibility transaction response for a Railroad Medicare patient. The message will say, “Railroad Retirement Medicare Beneficiary” in 271 Loop 2110C, Segment MSG.

If you use eligibility service vendors to check patient Medicare eligibility, contact them to find out how to get this and other information.

Here are some things you can do to ease the transition to the new cards:

  1. Sign up for CMS’ weekly MLN Connects newsletter to keep up with announcements.
  2. Attend CMS’ quarterly Open Door Forums to provide feedback on the transition. 
  3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different from the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
  4. Help Medicare patients adjust to their new Medicare card, and hang CMS's posters in your office (English and Spanish) available this fall  you can hang in your office and has published guidelines for talking to patients. CMS' partners and employers page also has additional resources.

Visit www.texmed.org/Medicare for more Medicare news and information.

Updated March 27, 2018  

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Last Updated On

March 28, 2018

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