Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Updated NaviNet transactions for QIPS-participatingproviders

January 9, 2014

[

As previously communicated, IBC is in the process of transitioning our claims processing system to a new platform,and this transition affects how you are paid for the Quality Incentive Payment System (QIPS) program.

During the migration, we will be working with you in a dual claims-processing and business-operating environmentuntil all of our business is on the new platform. Providers will likely have a mix of migrated and non-migrated memberson their panel.

For all members who have not yet been migrated to the new platform, all current business practices for QIPS willremain in effect, and we will continue to issue QIPS payments by paper check.

The following QIPS payment changes apply for members who have been migrated to the new platform:

  • Capitation and QIPS payments will be combined into one payment and disbursed each month via electronic fundstransfer (EFT) on the current capitation schedule. Please note that if your practice is not yet enrolled for EFT, youmust register through the NaviNet web portal. Refer to the EFT User Guide, available on IBC NaviNet Plan Centralunder Administrative Tools & Resources.
  • Retroactivity of up to six months will be applied to QIPS payments in the same way it is currently applied tocapitation payments.
  • You will only be able to view reports to support the QIPS payments at a member level on NaviNet ? paper copiesare not available for members who have been migrated to the new platform.

Note: To view reports for members of our Keystone Health Plan East affiliate in Northampton, Lehigh, Berks, andLancaster counties in Pennsylvania and New Castle County in Delaware, providers must access the appropriateNaviNet Plan Central.

Accessing your QIPS rosters on NaviNet

The following are brief instructions to help you navigate through the new QIPS Rosters transaction:

  • From the Plan Transactions menu, select ePayment, and then QIPS Rosters.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.