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New Medicare Cards – A Claim Professional's Simple Guide

From now until April 2019, Medicare is mailing new cards to over 60 million Americans with Medicare. If your case involves a Medicare beneficiary, there are some things to know that will help you manage the claim. 

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires Medicare to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.  Recently, the Centers for Medicare & Medicaid Services (CMS) have announced a process to execute this fraud protection program.

A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number (HICN) on the new Medicare cards for Medicare transactions like billing, eligibility status, and claim status beginning next April.  Currently, CMS use an SSN-based HICN to identify people with Medicare to administer the program.

The enhancements include:

  • Protection of private health care and financial information, and federal health care benefit and service payments
  • Unique, randomly generated, "non-intelligent" characters which are not associated with any other personal identification numbers (PINs)
  • More current systems to minimize cybersecurity threats involving medical identity theft

This new system will initially be a headache for all seasoned Workers Compensation, Liability and No-Fault adjusters, attorneys and claim professionals.  If you have a claim involving a Medicare beneficiary, be sure to obtain:

  1. A copy of the new card since it will provide the correct name of the beneficiary and new numbering system for fraud protection.
  2. The Social Security number of the beneficiary since Medicare and the Social Security Administration still rely upon the number for verification and tracking of benefits.
  3. The birthdate of the beneficiary.
  4. The alleged injuries, and specific body part information about the claim. Medicare has improved their systems to collect very specific data about the injuries of a particular incident, and administrators are prepared to sort out the injuries from other unrelated matters.

For more about the system and plans for implementation, visit CMS’s website describing the program >>

To learn more about how our Medicare Lien and Set Aside practices are achieving significant savings for our clients, contact Robert J. Blackburn at This email address is being protected from spambots. You need JavaScript enabled to view it. or 585-586-4530.

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By Robert J. Blackburn, Managing Principal, Blackburn Group, Inc., contact him at This email address is being protected from spambots. You need JavaScript enabled to view it..

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