It's Flu season again - Use Medicare Beneficiary Identifiers to Bill Medicare

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires The Centers for Medicare & Medicaid Services (CMS) to remove Social Security Numbers (SSNs) from all Medicare cards. CMS mailed new cards to all people with Medicare which have randomly generated Medicare Beneficiary Identifiers (MBIs) (PDF, 106 KB) instead of SSN-based Health Insurance Claim Numbers (HICNs).

Use MBIs to check eligibility and bill for influenza vaccinations to protect Medicare beneficiaries’ personal identities. Get the MBI:

  • Ask people with Medicare for their cards. If they did not get a new card, give them the Get Your New Medicare Card flyer in English (PDF, 563 KB) or Spanish (PDF, 575 KB).
  • You can look up MBIs for your Medicare patients when they don’t or can’t give them. Sign up (PDF, 103 KB) for the Portal to use the tool. You can use this tool even after the end of the transition period — the tool doesn’t end on December 31, 2019. Even if your patients are in a Medicare Advantage Plan, you can look up their MBIs to bill for things like indirect medical education.

You must have your patient’s SSN for the search and it may differ from the HICN, which uses the SSN of the primary wage earner. If your Medicare patient doesn’t want to give the SSN, tell your patient to log into mymedicare.gov to get the MBI.

If the lookup tool returns a last name matching error and the beneficiary’s last name includes a suffix, such as Jr. Sr. or III, try searching without and with the suffix as part of the last name.

  • Check the remittance advice. CMS included the new MBI on the remittance advice for each claim you submitted with a valid and active HICN since October, 2018, and will continue to return MBIs through December 31, 2019. Get the MBI from the remittance advice, save it in your systems, and use it to bill for this year’s flu vaccinations.

Tips for using MBIs:

  • Don’t use hyphens or spaces to avoid rejection of your claim
  • MBIs use 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”).

Starting January 1, 2020, you must use the MBI:

  • We will reject claims you submit with HICNs with a few exceptions
  • We will reject all eligibility transactions you submit with HICNs

For more information, please review CMS’ New Medicare Beneficiary Identifier (MBI), Get It, Use It (PDF, 213 KB) article.

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