Impact on medical billing by new medicare id card

Not only providing better health plans but the identity of its users should be secured is the main reason, why Medicare has released new cards for its users.

Total 21 months are given by Centers for Medicare & Medicaid Services (CMS) to providers, practices and medical billing companies for completely implementing the essential changes to their medical billing services and credentialing. The broadcast was made to allow medical professionals to completely comply with the freshly implemented Medicare ID card requirements.

Now the question is, what type of effect will these new modifications have on your billing services? Let’s begin by understanding the key changes with the new Medicare ID card-

There are 3 key differences in the new Medicare ID card:

• The elimination of the Social Security Number (SSN)
• The replacement of the policy id Health Insurance Claim Number (HICN)
• The use of the new Medicare Beneficiary Identifier (MBI)

What’s the main difference between the Insurance Claim Number (HICN) and Medicare Beneficiary Identifier (MBI)?

Due to growing cases of fraud risks and identity theft, the CHIP Reauthorization Act and Medicare Access required the CMS to eliminate the HICN. Because earlier member Medicare cards used to have the SSN centered Health Insurance Claim Number (HICN) that used as a chief identifier for cardholders. That’s why the CMS decided to eliminate the HICN.

Now Medicare beneficiaries will be provided with a new card having Medicare Beneficiary Identifier (MBI) instead of HICN that consists a combination of alphanumeric 11 characters separated by dashes except the uppercase letters S, L, O, I, B and Z.

The MBI is only a sequence of numbers and letters randomly generated by a system that does not have any special meaning.

How will this impact physicians and medical billing offices?

The new Medicare cards with Medicare Beneficiary Identification (MBI) are already being distributed and mailed out to beneficiaries. Which means recipients will soon be visiting physician offices with their new cards seeking assistance and better clarification on the use of New Medicare Cards. So, it’s really important for physician offices to completely prepared to address recipients’ concerns.

There are two types of concerns or challenges physician office may face with the New Medicare ID Card.

1. Insurance Eligibility Verification

The chief issue that physicians have to face will be verifying the new card’s authenticity and validity. The new card lookalike the previous one. However, take note of the new Medicare policy number, how it is made of uppercase letters and numbers alone. So, it is really important for physicians and medical billing offices to identify a valid Medicare ID card from a fraudulent one.

It looks very simple, but wait a minute, it’s not! Beneficiaries eligibility screening process also includes:

• Effective dates
• Benefits, calculations
• Administration, follow-up and plan execution

To easily verify the validity of the new cards, providers and medical offices can use Medicare Administrative Contractors (MAC’s) secure portal.

2. Coordination of Benefits

The main changes being done by CMS in Medicare ID cards is the use of the policy ID MBI number. CMS has not announced any other major change apart from the MBI unless an individual’s account is under any dispute.

Another major concern physician office may encounter is – a patient’s not receiving their new Medicare ID cards due to the change in their address.

How should a physician’s office manage this issue, if patient hand over the earlier version of the Medicare ID card?

Here doctors and billing offices should be proactive and update their patient’s about the change being done by Medicare and update their records.