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CMS: Use Medicare Beneficiary Identifier to Protect Your Patients’ Identity

Posted on Monday, September 9, 2019 11:51 AM

CMS is urging providers to use the Medicare Beneficiary Identifier (MBI) as soon as possible in order to protect their patient’s privacy.

Beginning January 1, 2020, providers must use the MBI otherwise it will be rejected by CMS. 

All HICN-based claims must be received by the January 1, 2020 – the cut-off date. On January 1, 2020, even for dates of services prior to this date, you must use MBIs for all transactions; there are a few exceptions when you can use either the HICN or MBI:

  • Appeals – You can use either the HICN or MBI for claim appeals and related forms;
  • Claim status query – You can use HICNs or MBIs to check the status of a claim (276 transactions) if the earliest date of service on the claim is before January 1, 2020. If you are checking the status of a claim with a date of service on or after January 1, 2020, you must use the MBI;
  • Span-date claims – You can use the HICN or the MBI for 11X-Inpatient Hospital, 32XHome Health (home health claims and Request for Anticipated Payments [RAPs]) and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before the end of the transition period (December 31, 2019). If a patient starts getting services in an inpatient hospital, home health, or religious non-medical health care institution before December 31, 2019, but stops getting those services after December 31, 2019, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019. Since you submit home health claims for a 60-day payment episode, you can send in the episode’s RAP with either the HICN or the MBI, but after the transition period ends on December 31, 2019, you have to use the MBI when you send in the final claim that goes with it.

Source: NAHC

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