New Medicare Cards

CMS has announced that facilities may need to change their healthcare records systems to:

  • Accept the new Medicare Beneficiary Identifier or MBI.  Use the MBI format specifications at https://www.cms.gov/Medicare/New-Medicare-Card/index.html if you currently have edits on the current HICN.
  • Identify your patients who qualify for Medicare under the Railroad Retirement Board (RRB).  You will no longer be able to distinguish RRB patients by the number on the new Medicare card.  You will be able to identify them by the RRB logo on their card, and we will return a message on the eligibility transaction response for a RRB patient.  The message will say, “Railroad Retirement Medicare Beneficiary” in 271 Loop 2110C, Segment MSG.  If you use the number only to identify your RRB patients beginning in April 2018, you must identify them differently to send Medicare claims to the RRB Specialty Medicare Administrative Contractor, Palmetto GBA at https://www.palmettogba.com/palmetto/providers.nsf/DocsCatHome/Railroad%20Medicare .
  • Update your practice management system’s patient numbers to automatically accept the new MBI from remittance advice (835) transactions.  Beginning in October 2018, through December 2019, CMS will return your patient’s MBI on every electronic remittance advice for claims you submit with a valid and active HICN.  It will be in the same place you currently get the “changed HICN”:  835 Loop 2100, Segment NM1 (Corrected Patient/Insured Name), Field NM109 (Identification Code).

If you use vendors to bill Medicare, contact them if they haven’t already shared their new Medicare card system changes with you; they can also tell you how they will pass the new Medicare number to you.  The New Medicare Card Provider webpage at https://www.cms.gov/Medicare/New-Medicare-Card/index.html will provide the latest information.

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