Recognize the New MBI
MLN Matters issued an article on July 11, 2018 to clarify that the Medicare Beneficiary Identifier (MBI) format does not use the letters S, L, O, I, B, and Z.
This was done so that there will never be a confusion between the numbers 5, 1, 0, 3, and 2. Keep in mind that whenever you see a 0, it is a zero and never the letter “O.” It appears that Medicare is more sensitive about mixing up letters with digits than is ICD-10.
Railroad Medicare is also mailing new cards using the MBI format. The Railroad Retirement Board (RRB) logo will be in the upper left corner of the card and it will say “Railroad Retirement Board” at the bottom for you to identify Railroad Medicare beneficiaries. You will not be able to tell a traditional Medicare beneficiary from a Railroad beneficiary from looking at the MBI, as we have been able to do in the past, before the MBI was implemented.
The new MBI will be used like the current Health Insurance Claim Number (HICN) is used today. The MBI is used in the CMS-1500 fields that require the HICN currently (requiring the Medicare ID). This also applies to reporting information only and no-pay claims.
It is important that you do not use the hyphens or spaces in the MBI on claim forms. Remittance advice will include the patient’s MBI in addition to the HICN beginning October 2018. Practices can start converting current patient insurance records to MBIs by using the remittance advice received as of October.
Billing can use either the HICN or MBI through Dec. 31, 2019. Beginning Jan. 1, 2020, the MBI will be the only identifier that will be accepted for billing, eligibility and claim status, and for inquiring about claims that may have been submitted using the HICN in 2019. You will, however, be able to use either the HICN or the MBI for appeals related to payment for claims submitted prior to Jan. 1, 2020.
Because the MBI does not change the beneficiary’s Medicare benefits, Medicare patients may start using their new Medicare cards and MBIs as soon as they receive them.
Protecting Patients’ MBI
AARP has recommended that beneficiaries not carry the original card with them for security reasons and you may find that some patients have a photocopy of their new Medicare card based on their recommendations. If you suspect a photocopied card is not valid, you can verify the patient’s MBI electronically in your MAC’s MBI secure look-up tool. The tool will indicate whether the card has been mailed to the patient. To sign up for the look-up tool for your MAC, go here and you will find the site for your MAC.
You can also go to the MAC’s secure MBI Look-up tool to look up a patient’s MBI. If the patient indicates that they have not received their new card, but the tool indicates the beneficiary’s geographic location where the card mailing is finished, tell the patient to call 1-800-633-4227 to request a new card.
Verify Primary Insurance
Keep in mind that Medicare patients that select Medicare Advantage plans are no longer entitled to Medicare Part B benefits. As a result, their Medicare card becomes invalid and their MBI will not get claims paid. If a patient gives the practice a United Healthcare Medicare Advantage card and a Medicare card, Medicare Part B is not a secondary insurance to United Healthcare. And because the United Healthcare plan is a Medicare Advantage plan, it is not secondary to Medicare Part B. Alternatively, if the patient provides a Medicare card and an AARP United Healthcare Medigap Insurance card, the United Healthcare plan would be secondary to the Medicare Part B. The insurance cards must be read carefully. It is highly recommended that eligibility be checked for all patients prior to seeing providers.
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