End of Medicare's Transition From HICN to MBI Use Looms

December 18, 2019 01:29 pm News Staff

Less than two weeks remain in the nearly two-year transition period during which family physicians have been able to continue billing and conducting other Medicare transactions using the health insurance claim number currently shown on beneficiaries' Medicare cards.

[New Medicare card showing Medicare Beneficiary Identifier]

Starting Jan. 1, health care professionals must submit claims -- regardless of service date -- using the randomly generated Medicare Beneficiary Identifier shown on the cards CMS has been distributing to beneficiaries since April of this year.

AAFP members will recall that the primary rationale for this change was to safeguard Medicare beneficiaries' identities by removing the Social Security number-based HICNs from Medicare cards. Additional background on the move to the new Medicare cards can be found on CMS' MBI home page.(www.cms.gov)  

CMS has outlined a number of specific exceptions to this directive. For Medicare plans, appeals, adjustments and certain other processes will continue to use HICNs. Fee-for-service claim exceptions also include appeals, as well as audits, claim status queries and more.

Visit the CMS website for more details on the transition process.(www.cms.gov) A broad array of training materials for various stakeholder groups(www.cms.gov) also can be accessed online, as can a comprehensive FAQ document.(www.cms.gov)