New Medicare Beneficiary Identifier (MBI)
OnIn an effort to enhance patient security and streamline healthcare processes, the Centers for Medicare & Medicaid Services (CMS) have transitioned from using the Health Insurance Claim Number (HICN) to the Medicare Beneficiary Identifier (MBI). This change, mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), aims to protect beneficiaries from identity theft and fraud.
What is MBI and Its Significance in Healthcare?
The MBI is a unique, randomly generated identifier assigned to each Medicare beneficiary. Unlike the HICN, which was based on an individual’s Social Security Number (SSN), the MBI consists of a combination of numbers and uppercase letters, ensuring enhanced security and privacy. This shift addresses concerns about the vulnerability of SSN-based identifiers and aligns with broader efforts to protect personal information in the healthcare sector.
Key Differences Between MBI vs. HICN
- Structure: The HICN included the beneficiary’s SSN followed by a suffix, whereas the MBI is a randomly generated sequence without any embedded personal information.
- Card Design: New Medicare cards featuring the MBI have a distinct design to differentiate them from the old SSN-based cards. Notable changes include the removal of gender designation, the signature line, and the “Hospital/Medical” labels, which have been replaced with “Part A” and “Part B” references. Additionally, the term “Effective Date” has been updated to “Coverage Starts,” and information is now provided in both English and Spanish.
- Usage Deadline: While there was a transition period allowing the use of both HICN and MBI, as of January 1, 2020, Medicare requires all claims to be submitted using the MBI. Claims submitted with the HICN are now rejected to ensure compliance with the new system.
Importance of Using MBI in Medicare Transactions
The adoption of the MBI is a critical step in safeguarding beneficiaries’ personal information. By eliminating SSNs from Medicare cards, CMS aims to reduce the risk of identity theft and fraud. Healthcare providers and suppliers are encouraged to use MBIs in all Medicare transactions to ensure compliance and protect patient data. CMS has also developed a secure tool that allows providers to look up MBIs at the point of service, facilitating a smoother transition and ongoing operations.
Ensuring Compliance with MBI Requirements
Organizations must adapt their systems and processes to accommodate the use of MBIs. This includes updating billing systems, training staff on the new requirements, and ensuring that all Medicare transactions are conducted using the MBI. Failure to comply can result in claim rejections and potential disruptions in service delivery.
The shift from HICN to MBI represents a significant advancement in protecting Medicare beneficiaries’ personal information. Understanding the differences between HICN and MBI and complying with the new requirements allows healthcare providers to contribute to a more secure and efficient Medicare system.
Our compliance consultants have over 40 years of experience providing research, analysis, and program support on privacy and security rules to clients in both the commercial sector and government sector to maximize compliance effectiveness. Call us at (703) 683-9600 or contact us online for a tailored assessment of your organization’s individual needs.
