Rexpert's Real-Time Insurance Eligibility Check

July 19th, 2017

Rexpert's Real-Time Insurance Eligibility Check

Beginning in April 2018, Medicare recipients will receive a new Medicare card that will have a randomly assigned 11-digit Medicare claim number (or policy number, to Rexpert users). This will replace the current policy number, which is based on the social security number. A year-long transitional period will follow, during which you can process Medicare claims using either the old or new Medicare number without any adverse effect on claim processing. However, beginning in April 2019, all claims will have to be processed using the new Medicare numbers.

CMS has put out out a list of things to do to get ready for the number change.  Rexpert will, of course, handle the new Medicare number format and will provide instructions for the April 2018 roll-out date.

One suggestion from CMS you can begin working on now is this:

Verify all of your Medicare patients’ addresses. If the addresses you have on file are different than the Medicare address you get on electronic eligibility transactions, ask your patients to contact Social Security and update their Medicare records.

As part Release 11.5, we are offering an Online Eligibility service which can be quite useful for checking addresses.  The report is fast and easy to use, and the patient's Medicare address shows up right on the summary:

You should compare the Online Eligibility address with the address in Account Registration. If the two addresses are different take one of these steps:

  • If the Online Eligibility address is correct, update the address in Account Registration.
  • If the Account Registration address is correct, advise the patient to contact Social Security to update his or her Medicare address. Otherwise, the patient may not receive his/her new Medicare card next year.

Well, that's it for now, and if you would like to know more about subscribing to the Online Eligibility service, please contact Client Services at (732) 383-4200