Experian Health – Voice Your Concern to CMS About New MBIs

Regarding the New Medicare Beneficiary Identification Project, Experian Health is providing you the opportunity to voice your concerns and send the attached recommended MBI Enhancement Request to CMS.

As we are all aware, the Medicare Beneficiary ID will be changing beginning in April 2018. While all of us advocate for Electronic Data Interchange standardization and compliance within the healthcare industry, there are some issues of which those who use Medicare’s eligibility system (HETS 270/271) should be aware. The current decision from CMS is that the MBI will be returned only on the eligibility response (271) if the MBI is used in the inquiry (270). CMS will require a provider to use a look up tool available through the individual MAC’s website when a provider cannot obtain the new MBI from the member. Additionally, CMS will be returning the MBI in the E1 NCPDP transaction (the pharmacy equivalent to the 270/271 transaction) if the HICN is submitted. Due to the complications this change will make to a provider’s workflow when registering a Medicare Beneficiary, we as an part of a larger EDI community have drafted a recommended enhancement request to CMS.

Please read the two links below that include a cover letter and instructions for the steps to follow to complete the attached template for the enhancement request to send to CMS. Experian Health has also sent this request to CMS.