New Medicare Beneficiary Identifier and What It Means for Providers

April of 2018 marks the beginning of Medicare’s transition to the new Medicare Beneficiary Identifier (MBI) which is slated to replace the current Health Insurance Claim Number (HICN) as the primary identifier for its beneficiaries.

Key information regarding MBIs:

• MBIs are randomly generated 11-digit identifiers
• MBIs contain uppercase alphabetic and numeric characters
• They will occupy the same field as the HICN on transactions
• They will be unique to each beneficiary – husband and wife will have their own MBI
• They will be smaller to match the size of a standard credit card
• They will be bilingual in English/Spanish
• They will not include gender and signature
• They will be printed on white paper and will still be red, white and blue coloring

Purpose of the New MBI Update

Medicare’s decision to move towards an updated MBI system was done to primarily prevent medical identity theft, protect private healthcare and financial information and safeguard federal healthcare benefits. The new MBI will apply to all existing, currently active, deceased or archived beneficiaries. If patients have Medicare Advantage or Part D, the new MBI will be separate from those insurers.

What Does This Mean for Providers?

The transition to MBIs prompts some operational questions and challenges for providers. At intake, providers will have to decide whether they ask for a patient’s HICN or MBI during the transition period as well as insuring that the patient knows to expect a new Medicare card. Providers should plan to perform training and outreach to their staff as well as their patient population to make them aware of these changes.

Implementation in the provider space will depend heavily on the provider’s Electronic Medical Record and its ability to accept the syntax of the new MBI, as well as in-built error checking against valid formats of the MBI. If these issues are addressed, the MBI should lead to far fewer or eliminate all transcription errors when documenting a patient’s Medicare number.

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Understanding the Transition to New MBI