Home Health

Requirement to use SSN-free Medicare numbers approaches, know what to do if numbers change

Agencies will soon be required to submit all claims using new Medicare beneficiary identifiers (MBIs), but agencies should be prepared for times when those MBIs change.

Medicare beneficiaries or their authorized representative can request to change the MBI if needed, as can CMS, according to a release from Medicare Administrative Contractor (MAC) CGS. This could happen if the MBI is somehow compromised, for instance.

It’s possible for patients to receive care before they get their new MBI card, however, CGS says. If you receive an error code stating “invalid member ID,” your patient’s MBI might have changed.

If this happens, CGS recommends doing the following:

  • Do a historic eligibility search to get the termination date of the old MBI.
  • If CGS is your MAC, get the new MBI from the CGS Web Portal, myCGS, MBI look-up tool. You will need to enter the patient’s last name, first name, date of birth, and social security number (xxx-xx-xxxx format).
  • Access the new MBI by assisting your patient with signing into MyMedicare.gov to obtain their new Medicare number.

Other MACs, such as Palmetto GBA, have their own look-up tools.

Providers will be required to use MBIs on claims beginning Jan. 1, 2020. CMS’ Social Security number removal initiative (SSNRI) is a drive to replace Medicare cards that have Social Security-based HICNs on them with new cards that have MBIs.

Until Jan. 1, 2020, CMS will accept claims whether they include an MBI or an HICN. The MBI will be 11 bytes long and will occupy the same field as the HICN on transactions.

Related link: Learn more about the myCGS MBI look-up tool at http://bit.ly/33lhQ5a. Learn about the Palmetto GBA look-up tool at http://bit.ly/2qDOVfA. For information about the issue, visit https://bit.ly/33pwnwY.