MLN Connects for August 8, 2019
Protect your patients’ identities by using the Medicare Beneficiary Identifier (MBI) now. Starting January 1, 2020, you must use the Medicare Beneficiary Identifier (MBI). We will reject claims you submit with the Health Insurance Claim Number (HICN), with a few exceptions, and reject all eligibility transactions.
Fee-for-Service claim exceptions:
- Appeals – You can use either the HICN or the MBI for claims, appeals and related forms.
- Audits – You can use either the HICN or the MBI for audit purposes.
- Claim status query – You can use either the HICN or the MBI to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you’re checking the status of a claim with a date of service on or after January 1, 2020, you have to use the MBI.
- Span-date claims – You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health (home health claims & Request for Anticipated Payments (RAPs)), and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before the end of the transition period (12/31/2019). You can submit claims received between April 1, 2018 and December 31, 2019 using either the HICN or the MBI. If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before December 31, 2019, but stops getting those services after December 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019.
- Incoming premium payments – People with Medicare who don’t get SSA or RRB benefits and submit premium payments should use the MBI on incoming premium remittances. But, we’ll accept the HICN on incoming premium remittances after the transition period. (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.)
- We’re monitoring the use of HICNs and MBIs to see how many of you are using MBIs. We’re also actively monitoring the transition to MBIs to be sure Medicare operations aren’t interrupted.
Don’t have an MBI?
• Ask your patients for their card. If they did not get a new card, give them the Get Your New Medicare Card flyer in English or Spanish.
• Use your Medicare Administrative Contractor’s look up tool. Sign up for the Portal to use the tool.
• Check the remittance advice. We return the MBI on the remittance advice for every claim with a valid and active HICN
