MLN Matters issued an article on July 11, 2018  to clarify that the MBI is not using 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 ICD-10 is.

Note that Railroad Medicare is also mailing new Railroad Medicare cards with the MBI.  The Railroad Retirement Board (RRB) logo will be in the upper left corner of the 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 has been implemented.

The new MBI will be used like the current HICN is used today.  The MBI is used in the CMS1500 fields that require the HICN currently (requiring the Medicare ID).  This also applies to reporting information only and no-pay claims.

Reporting MBI

It is important that you not use the hyphens or spaces with the MBI when using with a claim.  The hyphens assist you with entering the MBI but should not be included on the claim.  Remittance advices will include the patient’s MBI in addition to the HICN as of October 2018.  The practice can start converting current patient insurance records to MBIs by using the remittance advices received as of October.

Currently, billing can use either the HICN or the MBI, but after 12/31/2019 (as of January 1, 2020), the MBI will be the only identifier that will be accepted for billing, eligibility status and claim status.  On January 1, 2020, only the MBI can be used, even for inquiring about claims that may have been submitted using the HICN in 2019.  However, you can use either the HICN or the MBI for appeals related to payment for claims submitted prior to January 1, 2020.

Because the MBI does not change the beneficiary’s Medicare benefits, Medicare beneficiaries may start using their new Medicare cards and MBIs as soon as they receive them.

Protecting 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 the recommendations found in a few articles in AARP articles.  If you suspect that a photocopied card is not valid, you can verify the patient’s MBI electronically in your MAC’s secure 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 to:  https://www.cms.gov/Medicare/New-Medicare-Card/Providers/MACs-Provider-Portals-by-State.pdf 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 when the beneficiary doesn’t or cannot give the card to the practice to bill Medicare Part B, Railroad or DME.  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.

Keep in mind that Medicare age 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.  So, 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 would be secondary to the Medicare Part B.  The insurance cards must be read carefully.  And, it is highly recommended that eligibility be checked for all patients prior to seeing providers.