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Former President Harry S. Truman was the very first Medicare beneficiary to be issued a Health Insurance Claim Number (HICN) when then President Lyndon B Johnson signed the Medicare program into law on July 30, 1965. Ever since then, Medicare beneficiaries upon entitlement, have been issued a Health Insurance Claim Number (HICN). The primary issuer of the HICN is the social security administration with the railroad retirement Board issuing HIC numbers for railroad workers.

HICN numbers are made up of a nine-byte social security number plus a one to two character Beneficiary Identification Code. With the risk of identity theft becoming more and more prevalent CMS launched the Social Security Number Removal Initiative (SSNRI) years ago to remove the social security number from Medicare beneficiary identifiers and the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 clarified and hastened the implementation of this program.

Beginning in 2018 the Medicare HIC number will be replaced with a new identifier called a Medicare Beneficiary Identifier (MBI). The MBI numbers will be eleven bytes in length, randomly generated, and will derive no components from a beneficiary’s identification.

The characters used in this new identifier will be numbers from 0-9 and all letters from A-Z with the exception of the characters S, L, O, I, B, which were excluded to help make all the characters used easier to read. The format of this new identifier will look like this 1EG4-TE5-MK73. The 2nd, 5th, 8th, and 9th character will always be a letter and the 1st, 4th, 7th, 10th, and 11th characters will always be a number. The 3rd and 6th character will be a letter or a number.

The timeline for this transition looks like this:

  • January 2018 – CMS will generate 150 million MBI, 60 million for active beneficiaries and 90 million deceased or archived beneficiaries.
  • April 2018 to July 2019 – New and active enrollees will receive a new Medicare card with an MBI rather than a HIC number.
  • April 2018 to December 2019 – Providers may submit claims with either the patient’s HIC number or the patients MBI.

CMS has planned a generous phase-in period of 21 months to begin in April of 2018 and ending with a completed transition in December of 2019. Either the HIC number or the newly issued MIB can be utilized in healthcare transactions throughout this transition period. Beginning in October 2018 through the end of the transition period when a valid and active HIC number is submitted on a Medicare claim both the HIC number and the MBI will be returned on the Medicare remittance advice.

For claims that span the full implementation date (12/31/19) as well as claims under appeal that were originally billed with a HIC number the Hic number will be accepted beyond the transition date.

Providers should check with their software vendors and clearinghouses to make sure they are ready for this transitions.

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