DEPARTMENTS: PAYMENT STRATEGIES
The August 2017 Payment Strategies column, “Prepare Your Systems for the Social Security Number Removal Initiative,”1 discussed the Centers for Medicare & Medicaid Services’ (CMS’s) initiative to protect Medicare beneficiaries’ identities by removing social security numbers from Medicare cards. Even though the transition period does not end until December 31, 2019, wound care professionals and providers were encouraged to ready all their systems by April 1, 2018. The main reasons to be ready sooner rather than later are as follows:
- People who become Medicare eligible on or after April 1, 2018, will receive Medicare cards with the new Medicare Beneficiary Identifier (MBI) rather than the Social Security–based Health Insurance Claim Number (HICN). Between now and December 31, 2019, you can submit Medicare claims with either the HICN or the MBI. On January 1, 2020, even for dates of service before this date, medical professionals and providers must use MBIs on all Medicare claims.
- When people receive their new MBI and cards in the mail, the CMS directs them to properly dispose of their old cards to protect their identity.
The August 2017 article also encouraged wound care professionals and providers to educate their patients to watch for their new cards and to share them with their healthcare providers as soon as they are received.1
As a community service, this author provides educational programs to people with Medicare and/or their caregivers. Despite the information that was provided to every Medicare beneficiary in their 2018 Medicare & You book, and despite the numerous CMS public service announcements and emails, this author learned firsthand that many people have misperceptions about the new Medicare number and card. Therefore, this month’s compliance tips are provided to help wound care professionals and providers understand why they should take a proactive educational role with their Medicare patients and caregivers to compliantly bill the Medicare program using patient MBIs starting now and no later than January 1, 2020.
NOTE: The CMS has conducted message testing to learn what terms resonate with Medicare beneficiaries. Although this column uses official CMS terminology, when you provide education to patients, please keep these two things in mind:
- Instead of “Medicare beneficiary,” say “people with Medicare.”
- Instead of “Medicare Beneficiary Identifier,” say “Medicare number.”
Lack of Knowledge/Misperceptions about the New MBI and Card
Let’s begin by reviewing comments made by people with Medicare and/or their caregivers about the new Medicare number and card:
- “Someone from Medicare called me and told me I needed to prepay for my new Medicare number and card. I sent the money to the address provided, but I never received the new card.”
- “Are you sure we are getting new Medicare numbers and cards? I did not receive one. In fact, I was just at my physician’s office, and she/he did not tell me anything about it.”
- “I don’t like the new Medicare card because it is too flimsy, so I am going to keep using my old card.”
- “I can’t remember the new Medicare number, so I am going to keep using my old Medicare card!”
- “I threw the new Medicare card in the trash because I was afraid that my Medicare benefits would change if I used the new card.”
Wound Care Professionals/Providers Should Educate Their Patients about New Medicare Numbers and Cards
Even though the CMS has done their best to inform people with Medicare about their new Medicare numbers and cards, many people still do not understand the why, what, and how of this initiative that was put into place to help fight medical identity theft. After speaking with many people about this topic, this author is convinced that people with Medicare are waiting for their physicians/providers to tell them about the value of using their new Medicare numbers and cards.
The CMS created a plethora of free educational materials in both English and Spanish (eg, event flyers, slides, posters, “10 Things to Know About Your New Medicare Card” handouts, etc) that this author has enjoyed using in community outreach programs and that providers can use too. In addition, the CMS created a variety of communication resources to help providers “spread the word,” such as a video file to share with patients in your waiting areas, multimedia press resources, social media toolkits, public service announcement scripts, and more. Wound care professionals and providers should use these excellent resources, which are available at www.cms.gov/Medicare/New-Medicare-Card/Outreach-and-Education/Products-to-share-with-beneficiaries.html.
Below are some talking points that have resonated well with attendees at this author’s educational programs. Along with the materials available from the CMS, wound care professionals and providers may want to share some of these concepts with patients who are waiting to be educated. Your educational efforts will not only help your patients embrace their new MBI and card, but it will also help you compliantly bill Medicare using the patient’s MBI.
- The new Medicare numbers and cards will not change Medicare benefits.
- - Medicare is getting rid of the old card because the old Medicare number was based on a person’s Social Security Number. Scammers sometimes use Social Security Numbers to steal someone’s identity, open new credit cards, take out loans in someone else’s name, and so on.
- The CMS will never ask people with Medicare to give them personal or private information to receive their new Medicare number and card.
- - People with Medicare should not be misled by scam artists who try to get personal information (such as current or new Medicare numbers) by contacting them about their new MBI and card. Scammers hope that people with Medicare will not be informed about the new initiative and may try to use the opportunity to obtain personal information. Some scammers may even try to charge the beneficiaries for their new Medicare number and card.
- - Medicare, or someone representing Medicare, will only call and ask for personal information in these situations:
- People with Medicare should only give personal information such as their MBI to physicians, insurers acting on their behalf, or trusted people in the community who work with Medicare such as the State Health Insurance Assistance Program.
- Educate people with Medicare with these identity theft prevention tips:
- A Medicare health or drug plan can call if the beneficiary is already a member of the plan. The agent who helped the beneficiary join the plan can also call them.
- A customer service representative from 1-800-MEDICARE can call a beneficiary if the beneficiary called and left a message, or if a Medicare representative said that someone would return the beneficiary’s call.
Medicare is mailing the new cards in geographical waves.
- Do not pay for your new Medicare number and card. It is free. If anyone calls or approaches you and says you must pay for it, consider that a scam.
- Do not give your HICN or MBI to people you do not know or people you have not contacted.
- Do not give your bank account information to people you do not know.
- Do not let anyone trick you into believing your Medicare benefits will be canceled unless you give them your HICN or MBI.
- Destroy you old Medicare card when your new card arrives in the mail.
- Hang up and call Medicare at 1-800-MEDICARE (1-800-533-4227) if someone calls you and asks for your Medicare number, personal information, money, and/or threatens to cancel your health benefits if you do not comply.
- Contact the Federal Trade Commission at www.ftc.gov/contact if you suspect identity theft or feel like you gave personal information to someone you should not have.
The new cards are printed on paper for good reasons.
- - The new Medicare card will automatically be mailed to all people with Medicare. They do not need to do anything if their mailing address is up to date. If their address needs to be corrected, they should contact Social Security at www.ssa.gov/myaccount or by calling 1-800-772-1213.
- - Because Medicare must send new cards to all people with Medicare, they are mailing the new cards in geographical waves between April 2018 and April 2019. Medicare posts the approximate month they will begin mailing cards to each state at www.cms.gov/Medicare/New-Medicare-Card/NMC-Mailing-Strategy.pdf.
- - If the CMS has a beneficiary’s email address, they will send an email update when new Medicare numbers and cards start mailing in the beneficiary’s state. Once the CMS begins mailing new cards to their state, beneficiaries may receive their cards at different times than their family and friends because it takes time to complete the mailing to each state. If a beneficiary does not receive a new Medicare card by April 2019, she/he should call 1-800-MEDICARE (1-800-633-4227); TTY users can call 1-877-486-2048.
- - People with Medicare can proactively check to see if Medicare mailed their new card by logging in to their My Medicare account at www.mymedicare.gov. If they do not have a My Medicare account yet, encourage them to sign up. It is a free, secure, and easy way to access all their Medicare information in one place. NOTE: If the CMS already mailed a new card to the beneficiary and she/he did not receive it, she/he can print an official card if she/he has an established account.
- - Paper cards are easier for many medical professionals and providers to use and copy, and they save taxpayers a lot of money. Plus, if people with Medicare need a replacement card, they can print their own via their My Medicare account.
- - The new Medicare card includes the beneficiary’s name, MBI, and the dates that the beneficiary’s Medicare Part A and Medicare Part B coverage started. The new Medicare card does not include the beneficiary’s Social Security Number or their gender, and it does not require a beneficiary’s signature. See the Figure for a comparison between the old and the new Medicare number and card.
- - To protect the identity of people with Medicare, Medicare is removing Social Security Numbers from Medicare cards. Each person with Medicare will receive a new, unique MBI. Spouses or dependents whose old Medicare numbers were similar will each receive their own different Medicare number and card. This new unique number is a combination of numbers (0 through 9) and uppercase letters. The letters S, L, O, I, B, and Z are not used because they are difficult to distinguish from other, similar letters.
- - As stated above, people with Medicare should (1) appropriately destroy (shred or cut into very small pieces) their old Medicare card and start using their new Medicare number and card as soon as they receive it in the mail and (2) protect themselves by making sure no one can obtain personal information from their old or new Medicare cards.
- - People with Medicare should be instructed to guard their new card and give their new Medicare number only to doctors, pharmacists, other healthcare providers, insurers, or people they trust to work with Medicare on their behalf. They should show their new Medicare number and card to their healthcare providers when they need care. Wound care professionals and providers should remind patients that they know they are getting a new Medicare number and card and that they will ask them for their new card when they need care.
- - If the CMS mailed the new Medicare number and card to the patient, and if the patient forgets her/his new Medicare number and card, physicians or other healthcare providers can look up the MBI on their Medicare Administrative Contractor’s secure portal. To find MBIs in the portal, Medicare patients must provide their first name, last name, date of birth, and Social Security Number. If Medicare patients do not want to provide their Social Security Number, they can log into www.mymedicare.gov to get their new Medicare number and card.
- - If patients participate in a Medicare Advantage Plan, their Medicare Advantage Plan ID card is their main card for Medicare; they should keep and use that Medicare Advantage Plan ID card whenever they need care. However, they should also carry the new Medicare number and card they receive in the mail in case they are also asked to show it.
1. Schaum KD. Prepare your systems for the Social Security Number removal initiative. Adv Skin Wound Care 2017;30(8):350–2.