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March 28, 2019

Don't Wait: Submit Your Patients' MBIs on Claims Now!

As a result of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the social security number-based Health Insurance Claim Number (HICN) must be removed from the Medicare card and replaced with the new Medicare Beneficiary Identifier (MBI). The MBI will be used on all Medicare transactions in place of the HICN. New Medicare cards have been mailed with the new MBI.

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Beginning January 1, 2020, only the MBI will be accepted for all Medicare billing transactions, with limited exceptions. For additional information about the exceptions, refer to the SE18006External PDF Medicare Learning Network article.

CGS encourages home health and hospice providers to use the MBI before the end of the transition period, December 31, 2019, for all billing transactions.

How to Get the MBI

  • Ask your Medicare patients for their new Medicare card. If they haven't received a new card, give them the "Still Waiting for Your New Card?" handout (in EnglishExternal PDF or SpanishExternal PDF) or refer them to 1-800-Medicare (1-800-633-4227).
  • Use the myCGS MBI Look-Up Tool to obtain a patient's MBI. Follow the steps below. If you do not have access to myCGS, refer to the myCGS Web page for additional information.
    1. Once logged into myCGS, click on the MBI LOOKUP tab located in the header of the portal.
    2. Complete the required fields: Patient's last name, first name, date of birth, and social security number. NOTE: The social security number must be in the XXX-XX-XXXX format.

      NOTE: If your Medicare patients do not want to give their SSN, they can log into https://www.mymedicare.govExternal Website to get their MBI. If the look-up tool returns a last name matching error and the beneficiary last name includes a suffix, such as Jr. Sr. or III, try searching without and with the suffix as part of the last name.

    3. To meet our CAPTCHA requirements, you must select the I'M NOT A ROBOT checkbox.
    4. Click SUBMIT INQUIRY.

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      • If the social security number entered is not correct, an error message will display at the top of the page. Re-enter a valid social security number.

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      • If the social security number entered is correct, the MBI Look-Up Tool will display the patient's MBI in the lower-left corner of the page.

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  • Check your remittance advice for the MBI when you submit claims with valid and active HICNs.
    • CGS offers free PC Print software (for Medicare Part A providers & facilities) so you can see and print remittance advice information. For additional information refer to the Home Health and Hospice PC Print Download Available Web page.

      The PC Print also gives you the MBI when you submit a claim with a valid and active HICN. The PC Print Remittance Advice HICN label will display as Medicare ID (MID) and a new MID Corrected (MID COR) label and field was added, which will show the MBI in the ASC X12N 835 Loop 2100, NM109 of the Corrected Patient Name Segment

      Here's a PC Print exampleExternal PDF.

    • Standard Paper Remits (SPRs) will also give you the MBI when you submit a claim with a valid and active HICN. Here a FISSExternal PDF (Medicare Part A/Institutional) SPR example:

IVR and CTI Converter Tools

To assist you with entering your patient's information when calling the Home Health and Hospice Provider Contact Center (PCC), CGS offers the Interactive Voice Response (IVR) and Computer Telephone Integration (CTI) Convert Tool. This tool:

  • Converts the beneficiary's first initial of their first name and first six letters of their last name to the numbers necessary to enter on your telephone keypad.
  • Converts the 11 digit alpha/numeric Medicare Beneficiary Identifier (MBI) to the numbers/characters necessary to enter on your telephone keypad.

Don't wait till January 1, 2020, to start submitting your patient's MBI on your claims! If you have it, submit it! If you don't have it, get it!

Refer to the CMS New Medicare Card ProjectExternal Website webpage for additional information regarding this initiative.

If you have questions, please contact the Home Health and Hospice Provider Contact Center at 1.877.299.4500 and select Option 1.

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