CMS sent out the notice below last week in MLN. they have still not decided to allow vendors like Change Healthcare, Availity, or Experian Health to access this tool. If a Medicare beneficiary presents without their new card and they’re in one of the states that has received their cards, you will have to log onto the MACs site to find the new number.
All Medicare Administrative Contractor (MAC) secure portal Medicare Beneficiary Identifier (MBI) look-up tools are ready for use. If you don’t already have access, sign up for your MAC’s portal to use the tool.
Submit four data elements about your patient through the tool, and we will return the MBI if we have already mailed the new Medicare card. Medicare is mailing new cards in phases by geographic location. For more information about the MBI, read the MLN Matters® Special Edition Article.
We are currently mailing new cards to people who:
- Live in Alaska, American Samoa, California, Delaware, District of Columbia, Guam, Hawaii, Maryland, Northern Mariana Islands, Oregon, Pennsylvania, Virginia, and West Virginia
- Get Railroad Retirement Board benefits
- Are newly entitled to Medicare
Medicare Eligibility Response Changes June 2018
CMS will be making the following changes their eligibility response this month.
- CMS will start allowing service type code CQ to be requested. CQ (Case Management) should be sent when requesting eligibility information on the Medicare Diabetes Prevention Program.
- Responses for providers that are identified as an MDPP provider will change. If an eligibility response is received for a provider that has a D1 specialty code in their NPI file, the response will only return the following:
• Medicare Beneficiary Demographics
• Date of Death
• Unlawful Occurrences
• Medicare Part B Entitlement
• MDPP Coverage
• MDPP Financial Information
• Medicare Advantage Enrollment(s)
• Medicare as a Secondary Payer (MSP) Enrollment(s)