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Medicare Beneficiary Identifiers to Replace Social Security-Based Health Insurance Claim Numbers

Beginning in April 2018, The Centers for Medicare & Medicaid Services (CMS) will begin to transition Medicare beneficiaries to a new identification system. The transition intends to help protect Medicare beneficiaries against fraud and identity theft. Medicare beneficiaries will receive new identification cards and be assigned new Medicare Beneficiary Identifiers (MBIs), which will replace the currently utilized Social Security-based Health Insurance Claim Numbers (HICNs).  

This transition comes as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). It will provide Medicare beneficiaries more secure identification through a system of assigning unique and randomly-selected numbers as a beneficiary’s identification, rather than a beneficiary’s Social Security number. Through MACRA and its elimination of Social Security-based identifiers, Medicare beneficiaries’ private information will be better protected, including their health care and financial information, as well as adding safeguards to their federal health care benefits and service payments.     

CMS plans to begin issuing new Medicare identification cards in April 2018, with all cards replaced by April 2019. The new cards will display the unique and randomly-assigned Medicare beneficiary numbers.  Each beneficiary’s individual number will be recognized as their MBI. CMS anticipates there will be a 21-month transition period, during which time all health care providers will be able to use either a patient’s MBI or HICN for billing purposes. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will also align with the 21-month transition period, and accept MBIs and HICNs through its duration. Both the MBIs and the HICNs will be mapped within Blue Cross NC‘s claim processing system, which will accommodate the submission and processing of claims for both primary and secondary coverage types.  

It’s important to note that the transition of HICNs to MBIs is specific to the member identifiers assigned for members enrolled in Original Medicare. Members enrolled in Blue Cross NC’s coverage plans will continue to utilize Blue Cross NC assigned member IDs, which include alpha-prefixes, randomly assigned numbers, and numeric suffixes. Additionally, other than replacing the HICN with the MBI on claims reporting services for patients covered under Original Medicare, the processes for submitting claims to Medicare, as well as Blue Cross NC when we are a patient’s secondary coverage to Medicare, will not change due to this transition. However, the transition from HICNs to MBIs may affect your patient record systems and systems that support the filing of claims. To assist with these changes, CMS has outlined steps to help providers’ offices to prepare: 

  • Learn about and use the CMS offered MBI format specifications to make changes to your systems.  Test system changes and work with billing office staff to be sure your office is ready to use the new MBI format. 
  • If you use a clearinghouse or vendor, discuss with them their plans for making the transition. 
  • Verify all of your Medicare patients’ addresses. If an address on file is different than the Medicare patient’s address on the electronic eligibility transaction, ask patients to contact Social Security and update their Medicare records. 
  • Work with CMS to help your Medicare patients adjust to their new Medicare cards.