How Practices Can Start Preparing for New Medicare Cards

CMS will issue new Medicare cards starting in April 2018 with a new unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI) to replace the existing Social Security-based Health Insurance Claim Number (HICN) both on the cards and in various CMS systems we use now. However, both the MBIs on the new cards and the Social Security­ based HICNs that exist on the cards today, can be used. Here's what you need to know to start preparing your practice for new Medicare cards.

Why is CMS Issuing New Medicare Cards?

“We’re taking this step to protect our seniors from fraudulent use of Social Security numbers, which can lead to identity theft and illegal use of Medicare benefits,” said CMS Administrator Seema Verma in a May 30 announcement.

Medicare is taking steps to remove Social Security numbers from Medicare cards to prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of Medicare beneficiaries. The transition is mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). 

When will the transition happen?

CMS will start mailing new cards to people with Medicare benefits in April 2018. All Medicare cards will be replaced by April 2019.

Billing Claims During the Transition to New Cards

Even though your systems will need to be able to accept the new MBI format by April 2018, you can continue to bill and file healthcare claims using a patient’s HICN during the transition period.

The transition period occurs over 21 months which will end in December 2019. Rob Tennant, director of health information technology policy for MGMA emphasized that CMS won't just send the cards out all at once and expect beneficiaries to start using them.

Providers also won't need to wait on the patient's new card to get their number according to Tennant. "During the transition, providers can still use the HICN and when the 835 remittance comes back on a patient's encounter, it will reveal the new MBI to the provider, who ideally will update their practice management system with the new number," says Tennant.

CMS is developing capabilities where doctors and other healthcare providers will be able to loop up the new MBI through a secure tool at the point of service. In the mean time, you'll need to communicate with your billing service provider or in-house billing staff during this transition to ensure a clear process is in place for the new Medicare cards. By having an understanding of the changes ahead and outlining a process to manage the transition, payments can be received in a timely manner and cash flow disruptions can be avoided.

Related: 4 Common Mistakes that Lead to High Accounts Receivables

How to Communicate the Change to New Medicare Cards to Patients

Beginning in April 2018, Medicare patients will come to your office with new cards in hand. Being proactive in communicating the change to your patients will help patients adjust without confusion or frustration. 

CMS will release more information this fall that you can provide to your patients but don't rely solely on CMS to communicate the change to new Medicare cards.

Consider how your practice currently communicates with patients about billing or ID changes. Can you send out a message via email, text, or voicemail to inform Medicare beneficiaries of the card changes that are expected to take place? What about their family and caregivers who will also need to know about the change?

Most modern-day EHR systems have a patient portal or a messaging tool built in that allows practices to send out mass communication to a particular audience. This is a great way to communicate with your patients but also keep in mind that just sending just one message doesn't mean you've done all that you can in communicating with patients.

Multiple messages over time across multiple mediums like email, text, web portal, mail, posters in your office, and even phone calls (if you have the resources available) is a great way to prepare patients. You don't want to leave room for gaps in your communication plan and over communicating is one way to ensure that each Medicare beneficiary is aware of the new cards that will be arriving at their doorstep and what to do with them.

Help Patients Avoid Fraud 

When communicating the new cards to your patients, you should also remind them to beware of fraud and scammers. The new cards present an opportunity for scammers to target patients and request that they update their information over the phone.

Make sure patients understand that Medicare already has the required information to update a beneficiaries card. Anyone that calls to confirm the current Medicare number before sending the new card or claims that there is a charge for the new card, is attempting fraud.

Even if the person claims to be with Medicare, patients must understand to never give out their personal information over the phone including banking information. If patients receive calls requesting this information or suspicious solicitations, inform them to hang up and call the Senior Medicare Patrol (SMP) or Medicare directly at 1-800-MEDICARE (1-800-633-4227).

The contact information for the SMP can be found online and varies by state. Use the SMP Locator to select your state and receive appropriate contact information for your patient population-

Training Your Staff

You also need to consider how you are planning on training your staff to handle questions about the card changes. Make sure they have the necessary information ahead of time to answer patient questions with confidence and can communicate why the change is necessary (to prevent identify theft, etc.). Creating a short FAQ document can help your staff answer common questions that you can anticipate from patients such as:

  • When will my new card arrive?
  • What should I do with my old Medicare card?
  • Why is CMS changing my card?
  • Will this affect my healthcare coverage?
  • Do I need to call all of my care providers to inform them of my new number?

CMS Resources to Assist with the Transition

CMS is your best resource for information regarding the transition to new Medicare cards. We will continue to publish updates here on GroupOne's Practice Management blog so be sure to subscribe today if you haven't already.

Here are a few steps CMS recommends practices take today to prepare for new Medicare cards: 

  1. Go to the CMS provider website and sign-up for the weekly MLN Connects® newsletter.  
  2. Attend the CMS quarterly calls to get more information. The MLN Connects newsletter will notify you of when calls are scheduled.
  3. Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.
  4. Work with CMS to help your Medicare patients adjust to their new Medicare card. Once information becomes available later this fall, you can display helpful information about the new Medicare cards in your practice. Hang posters about the change in your offices to help us spread the word.
  5. Test your system changes and work with your billing office staff to be sure your office is ready to use the new MBI format.

The Advantage of Using RCM Experts When Acquiring a Medical Practice
The Advantage of Using RCM Experts When Acquiring a Medical Practice
How to Boost Revenue Using RCM for Medical Practices
How to Boost Revenue Using RCM for Medical Practices
How to Optimize Your Clinical Workflow for Telehealth
How to Optimize Your Clinical Workflow for Telehealth
Five Reasons You Shouldn’t Piece Together Your Healthcare RCM
Five Reasons You Shouldn’t Piece Together Your Healthcare RCM
7 Revenue Cycle Management Best Practices
7 Revenue Cycle Management Best Practices

Join the 1,000+ healthcare professionals already receiving updates.