How Will the Social Security Number Removal Initiative (SSNRI) Affect Your Practice? Stay Ahead of Potential Setbacks

With identity theft rampant and posing a major risk, especially to the elderly population that is often targeted and vulnerable to such fraud, the Centers for Medicare & Medicaid Services (CMS) has implemented the SSN Removal Initiative.  This initiative is designed to better protect health care and financial information against the risk of identity theft.  

The Medicare Access and CHIP Reauthorization Act of 2015 requires that social security numbers be removed from all Medicare cards and be replaced with a Medicare Beneficiary Identifier (MBI).  Currently, a nine-digit SSN-based identity number is used for identification purposes for processing Medicare claims.  Starting in April 2018, new Medicare ID cards will be issued and mailed to existing and new beneficiaries. All new cards will be issued by April 2019, with the entire transition period expected to be completed in December 2019.  

Under the new system, SSNs will be replaced by a new randomly generated 11-character identifier, which will include both alphabetic and numeric characters.  All Medicare claims submitted after January 2020 will be required to use the MBI.  Claims filed after the transition period with a patient’s social security number will be rejected.  According to the CMS, this process will affect approximately 60 million Medicare beneficiaries.

Proactively preparing for the transition

Doctors’ offices, hospitals, and other providers have expressed concerns about potential disruption of care and delay in claims payments caused by a provider’s inability to access a patient’s MBI during and after the transition period.  Patient confusion about the new cards and those who do not present the new card at the time of service can also pose problems for providers.  Provider groups should have processes in place in order to ease the transition.  
In determining what changes need to take place in your practice, conduct the following assessment:

• Review your practice management system and talk to medical software vendors to make sure that your system is ready to accept the new 11-character MBI’s
• Communicate with third-party clearinghouses and third-party insurance plans to make sure that they are ready for the change
• Train your staff
• Communicate with patients about the new Medicare ID cards  

What Does CohnReznick Think?

While the goal is to provide greater protection of patient data, the transition to new Medicare numbers and cards will require some changes to existing systems. This may have an impact on providers and vendors as well as beneficiaries.  Being prepared, having processes in place, and being ready to implement changes will help mitigate any disruption to your practice as a result of this transition.   

Contact

For more information, please contact Susan Cooper, Senior Manager, at [email protected] or 732-380-8634, or Peter R. Epp, Partner and Healthcare Industry Leader, at  [email protected] or 646-254-7411.