CMS MLN Matters Number: SE18006 Reissued

PROVIDER ACTION NEEDED

Use MBIs for all Medicare transactions. The Centers for Medicare & Medicaid Services (CMS) replaced the Social Security Number (SSN)-based Health Insurance Claim Numbers (HICNs) with the MBI and mailed new Medicare cards to all Medicare beneficiaries. The cards with MBIs offer better identity protection.

With a few exceptions, Medicare will reject claims you submit with Health Insurance Claim Numbers (HICNs). Medicare will reject all eligibility transactions you submit with HICNs.

Exceptions
You MUST submit claims using MBIs, no matter what date you performed the service, with a few exceptions:

• Appeals – You can use either HICNs or MBIs for claim appeals and related forms.

• Claim status query – You can use the HICN or MBI 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 HICNs or MBIs for 11X-Inpatient Hospital, 32XHome Health (home health final 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, you may submit a claim using either the HICN or the MBI, even if you submit it after December 31, 2019.

Leave a Reply

Your email address will not be published. Required fields are marked *