MDS Alert

Published on Fri Feb 07, 2020 PDF

Hint: If a resident has Medicare, then their MDS must have their MBI to be accurate.

Some MDS coordinators are finding Medicare residents’ MDS assessments are being rejected and returned — and then finding out that they don’t have the Medicare Beneficiary Identifier (MBI) in their records or on the MDS. If you’re waiting around for residents’ families to supply you with the MBI, rejoice, because there’s an easier way to get the information you need.

Background: “The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) required CMS to remove SSNs from all Medicare cards. CMS replaced the SSN-based HICN with a new, randomly generated MBI. The MBI hyphens on the card are for illustration purposes: don’t include the hyphens or spaces on transactions. The MBI uses numbers 0-9 and all uppercase letters except for S, L, O, I, B, and Z. We exclude these letters to avoid confusion when differentiating some letters and numbers (for example, between “0” and “O”). Review the MBI specifications format,” say the Centers for Medicare & Medicaid Services (CMS) in an informational bulletin about MBIs.

Although physicians’ offices and some other providers are instructed to ask their patients for the MBI, all Medicare Administrative Contractors (MACs) have secure look-up tools that you can utilize to find a resident’s MBI. You need the resident’s Social Security Number (SSN) — which may differ from the resident’s old Health Insurance Claim Number (HICN) — in order to use the tool. If you do not have access to the resident’s SSN and they won’t provide you with it or the MBI, CMS instructs you to suggest that the resident log into  www.mymedicare.gov.

For residents who do not have or use Medicare, most MDS software programs allow you to bypass the A0600B (Social Security and Medicare Numbers) by leaving blank or using dashes for information not known. Note that the RAI Manual, on page A-14, says that if a SSN is not available, “the item may be left blank.”