March 01, 2018 12:14 pm Sheri Porter –
It's just a matter of weeks until CMS begins mailing new Medicare cards to beneficiaries. As physicians likely know, the cards will no longer identify a person by his or her Social Security number; rather, the old Health Insurance Claim Number (HICN) will be replaced with a unique Medicare Beneficiary Identifier (MBI) that consists of random numbers and uppercase letters.
The whole point of the transition is to protect patient identities and keep personal information more secure.
Card distribution will start on April 1 via a phased-in process based on geographic location. The transition will be complete by Dec. 31, 2019, at which time physicians must rely only on MBIs for all billing and Medicare transactions.
The last day of 2019 may sound like a long way off, but family physicians must not be complacent.
Barbie Hays, C.P.C., the AAFP's coding and compliance strategist, sat down with AAFP News to answer a few questions about why this change is a really big deal to all practicing family physicians.
Q. Why should family physicians care about patients receiving a new version of their Medicare cards?
A. Physicians should care if they want to continue to be paid by Medicare. The format of the card is changing, and physicians need to know if their electronic health records (EHRs) and claims processing systems will accept the new format -- and if their electronic clearinghouses are geared up to accept and transmit the data on the new cards.
CMS has allowed for a phase-in period. However, physicians need to be ready on April 1 because regardless of the transition schedule, if a patient becomes newly eligible for Medicare on, say May 6, he or she won't get a card in the old HICN format. That patient will have been issued a card in the new format with the new MBI.
CMS has lots of free resources ready and waiting for physicians to order. Take advantage of patient education pieces on the new Medicare cards that will start hitting mailboxes soon. CMS offers helpful tools on a variety of other topics and programs, too.
One note of caution from AAFP coding and compliance strategist Barbie Hays, C.P.C., who told AAFP News she recently set up a CMS account of her own and found the process a bit cumbersome: Users must request an account with CMS by filling out a short online form. A few days later, users should be able to enter the system, browse CMS products and order anything available on the site for no charge.
Q. Will front desk staff be able to recognize a new Medicare card at first glance?
A. The card itself will look slightly different. It's made of heavyweight white card stock and is slightly smaller that the current card. The new cards are the same size and shape as a credit card or a driver's license and made to slip easily into a wallet. The new cards utilize the traditional red and blue colors with black printing. But there is less information on the card; there is no birthday or gender designation; those identifying factors have been removed to protect each patient's identity.
Q. What one thing do physicians need to know today?
A. Be prepared to accept the new numbers now. Be working with your clearinghouses and software vendors now, and know if they are able to accept the numbers and transmit them. I don't think it is a problem for most vendors; however, if a software program is hardwired to only accept 10 digits for a particular insurance plan, that's when a problem will arise. Make that verification now.
Q. What else should physicians do to prepare for this transition?
A. Inform your patients using subliminal messaging. Use the literature CMS provides for free (see box at left) and display it prominently. Print CMS posters out and put them in every exam room, in hallways and above the scale where patients are weighed. Put a poster on an easel in your front office to catch the eye of every patient who walks in the front door.
One particularly useful tool physicians may want to check out is a new video from CMS that can be played in the office's reception area. At just over a minute long, the video is available on YouTube and in open-captioned and 1080p formats.
It's also a good idea to have front office staff ask patients to make sure their addresses are updated online with Medicare or with the Social Security Administration.
Q. What else do patients need to know?
A. Medicare and the Social Security Administration are asking physicians to share three important tips with patients. Tell them to
Hays said the single most important take-home point for physicians is this: "Update your systems. I can't stress that enough. There should still be time to do that, though it depends on your vendor and your clearinghouse."
Even physicians who are employed by a hospital or a large health care system should ask about the system updates, said Hays. "Just ask. Sometimes things do fall through the cracks.
Related AAFP News Coverage
CMS Resources Help Practices Transition to New Cards
New Medicare Beneficiary Numbers Coming Soon
(11/20/2017)
More From AAFP
FPM Getting Paid blog: Time to educate your patients about new Medicare cards
(2/7/2018)
Additional Resource
CMS: What do the new Medicare cards mean for providers?