Will the MBI Transition Impact Your Reimbursement?

by Shelley Hansell, SVP, Client Relations & Revenue Cycle Product Management

January 1, 2020 is an important date for pharmacies that process medical claims under Medicare Part B. If you administer immunizations, dispense diabetic supplies or provide DME items to Medicare beneficiaries, your reimbursement may be at risk.

If you’re not familiar with the HICN to MBI transition, here’s a quick summary. Centers for Medicare & Medicaid Services (CMS) has traditionally used social-security-based numbers called HICNs to identify Medicare members. Over the past four years, CMS has been transitioning from HICN to a new member number called the Medicare Beneficiary Identifier (MBI). Starting on January 1, all claims submitted to Medicare will require a MBI for claim reimbursement, even if the date of service is prior to January 1. Claims sent without a MBI will be rejected.

How do you know if your medical claims are ready for the MBI transition? If you’re an XiFin Pharmacy Solutions customer, good news! You are all set. We’ve been working through this transition for the past two years, and as of November, over 95% of the claims processed by the 20,000+ XiFin Pharmacy Solutions pharmacy customers are already using the MBI. If you use a different vendor for medical claims processing, we recommend you reach out to them as soon as possible to make sure they are set up to process your claims with the MBI.

If you would like to learn more about Medicare Part B and how we can help, feel free to reach out to us for additional guidance.

Shelley Hansell

EVP Client Relations & RCM Product Management, XiFin Pharmacy Solutions

Formerly, Shelley served as the executive vice president of client relations, and revenue cycle product management, responsible for building client partnerships and implementing products and services that mutually grow businesses. With nearly 20 years of domain experience, Shelley is well respected in the pharmacy industry for her revenue cycle management expertise as well as her ability to drive operational improvements aligned with medical billing policies.