Billing Verification Changes

eMedNY is making changes to their data systems to accept Medicare Beneficiary Identifier (MBI) data. The changes are being made to support dual eligible (Medicare and Medicaid) beneficiaries as they begin using their new Medicare cards. Beginning Sept. 20, 2018, the Eligibility Response for dual eligible beneficiaries will return the new MBI when using ARU, ePACES, and POS Devices for 270/271 Transaction verification. During the MBI transition period (through December 2019), if the MBI is unavailable, the Health Insurance Claim Number (HICN) will be returned. Once the MBI transition period is complete (January 2020), only the MBI will be returned during eMedNY eligibility verification.

Providers who use ePACES to verify eligibility should inform their staff that beginning Sept. 20, 2018, the ePACES Eligibility Response Medicare Information Section’s HICN label will now read "Medicare Identifier." Providers who use POS devices to verify eligibility should inform their staff that the MBI will be displayed even though the HICN Tag will not change.

Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820