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 OmniSYS 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+ OmniSYS 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.

More To Explore

New Decade, New Pharmacy Model

by David Pope, PharmD, CDE, Chief Innovation Officer

More pharmacists are scheduling patient appointments and providing billable clinical services with patients than ever before.

logo omnisys
Blog Post

Strand-Rx Food Insecurity Program

by David Pope, CDE, PharmD, Chief Innovation Officer

Food insecurity is defined as “a lack of consistent access to enough food for an active, healthy life.” This directly relates to a lack of resources needed to provide food. In many cases, patients are forced to make a choice between buying food and being able to buy their medication. We begin a pilot program in Augusta, GA with a local pharmacy and a local food bank with goal of making a positive impact on food insecurity in the region. Through this collaboration, the program addressed both physiological and safety needs.