Are You Ready for the New Medicare Beneficiary Identifier?

If you haven’t seen the new Medicare Beneficiary Identifier on a Medicare card yet, be on the lookout because you are likely to start seeing them soon. As of April 1, 2018, all new Medicare beneficiaries began receiving a Medicare Beneficiary Identifier (MBI) instead of the old Health Insurance Claim Number (HICN) which included a Social Security Number.

The change from HICN to MBI is required as part of the Medicare Access and CHIP Reauthorization Act (MACRA) and is intended to reduce the risk of identity theft and cut down on fraudulent use of Medicare benefits. 

While your first response may be, “Ugh, another number we have to get from our patients,” the reality is that the transition should be relatively painless as long as you are prepared.

Here are a few tips to make sure that you are ready when the transition is fully in effect by December 31, 2019. Yes, you have plenty of time, but don’t wait to begin your preparations. New Medicare cards will be showing up in your office before you know it!

Confirm that Your Vendors are Ready

Most software vendors and clearinghouses have been preparing for the change in MBI, but it’s a good idea to confirm that the systems you use are prepared for the new MBI. As of April 1, 2018, new beneficiaries only receive the MBI. The MBI will be used for all electronic transactions, including claims, claim status, eligibility and remittance advice. It will also be used for interactions with Medicare contractors.

Make Sure You and Your Staff Are Familiar with the New Cards and Format

We have all gotten used to the familiar HICN format of the SSN followed by a letter. The new format has a very different look and is a randomly generated identifier with a combination of 11 letters and numbers. 

Example MBI: 1EG4-TE5-MK72

Be sure everyone is trained to identify the new number and knows how to enter it in your system. Just like the old numbers, the dashes are not required for claim submission.

The cards will look a little different too. One key difference will be how you identify a Railroad Medicare beneficiary from a traditional Medicare beneficiary. They will both have the same MBI format, however there will be a logo in the upper left corner of the card. Traditional Medicare cards will have the CMS logo and Railroad Medicare cards will have the Railroad Retirement Board logo. Here are samples of each card available, courtesy of the CMS website article, Transition to New Medicare Numbers and Cards, under the Medicare Learning Network.

New Medicare Cards

Get Access to the New MBI Lookup Tool

Make sure you are signed up for access to your Medicare contractors portal. This will provide you with access to the MBI lookup tool that will be available beginning June 1, 2018. This tool will allow you to find a beneficiaries MBI using a few pieces of demographic information.

Why is this so important? Well, for starters, new cards are being mailed to existing Medicare beneficiaries. If the beneficiary has not updated their address with Medicare and/or the Social Security Administration, they may not receive their card. Since most beneficiaries receive their Social Security checks via direct deposit, there is a very good chance that if a beneficiary has moved since they received their original Medicare card, they may not have updated their address.

Ask Existing Medicare Beneficiaries to Update their Address with Medicare

If the address you have on file for a Medicare patient is different than what you see when you do an eligibility verification, ask them to contact Social Security to update their information. They can do this by either calling Social Security at (800) 772-1213 or by going online if they have set up an account at

If they are a Railroad Medicare beneficiary they need to call the Railroad Retirement Board at (877) 772-5772.

With a little preparation, the transition to the new Medicare Beneficiary Identifier should be relatively painless compared to other transitions we have all endured, such as NPI and ICD-10. Be proactive and review your current process for collecting beneficiary information and you may find that your overall process will improve.

About the Author

Aimee Heckman is a Healthcare Business Consultant with more than 25 years of experience in Medical Practice Management, Revenue Cycle Management, PM/EHR...

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