Be Prepared – For the Social Security Number Removal Initiative (SSNRI)

by  Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Jul 20th, 2017

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.   Beginning April 2018, CMS will begin sending out new Medicare cards to Beneficiaries.  Replacing the Social Security Number will be the Medicare Beneficiary Identifier or MBI. 

Be sure your computer systems can handle the new formatting. HICNs can be up to 11 characters while MBIs will be 11-characters in length. For example: 1EG4-TE5-MK73

 The MBI’s 2nd, 5th, 8th, and 9th characters will always be a letter.

• Characters 1, 4, 7, 10, and 11 will always be a number.
• The 3rd and 6th characters will be a letter or a number.
• The dashes aren’t used as part of the MBI. They won’t be entered into computer systems or used in file formats.

As with HICNs, you will not use spaces or dashes on your claim form.

CMS will not offer end-to-end testing as you will be able to use either the HICNs or MBIs during the transition period. The transition period will begin no earlier than April 1, 2018 and run through December 31, 2019. By January 2020 the transition period will be over, and you will be required to only use MBI’s with a few exceptions.

 CMS the exceptions would be for:

• Appeals - You can use either the HICN or the MBI for claims appeals and related forms.
• Adjustments - You can use the HICN indefinitely for some systems (Drug Data Processing, Risk Adjustment Processing, and Encounter Data) and for all records - not just adjustments.
• Reports - We’ll use the HICN on these reports until further notice:
• Incoming to us (quality reporting, Disproportionate Share Hospital data requests, etc.)
• Outgoing from us (Provider Statistical & Reimbursement Report, Accountable Care Organization reports, etc.)

 Fee-for-Service claim exceptions:

• Appeals - You can use either the HICN or the MBI for claims appeals and related forms.
• Span-date claims - You can use the HICN for 11X-Inpatient Hospital, 32X-Home Health, and 41X-Religious Non-Medical Health Care Institution claims if the “From Date” is before the end of the transition period (12/31/2019).  You can submit claims received between April 1, 2018 and December 31, 2019 using the HICN or the MBI.  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.
• Home health claims & Requests for Anticipated Payments (RAPs) - You can use MBIs or HICNs on home health claims and RAPs with a from date before January 1, 2020.  Because you submit home health claims for a 60-day payment episode, there may be times when an episode ends after the transition period on December 31, 2019.  If the from date on the RAP or the final claim date is before December 31, 2019, you may submit either the HICN or the MBI, but you must submit the MBI for RAPs and final claims when the from date is on or after January 1, 2020.
• Incoming information requests - (inquiries, Medicare Secondary Payer information requests, Requests for Medical Documentation, etc.)
• Incoming premium payments - People with Medicare who don't get SSA or RRB benefits and submit premium payments should use the MBI on incoming premium remittances, but we'll accept the HICN on incoming premium remittances after the transition period.  (Part A premiums, Part B premiums, Part D income related monthly adjustment amounts, etc.)

For more information visit CMS.gov