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Participating providers must submit all claims for IBC members to IBC
Professional; Facility
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If you are a participating provider with IBC submitting claims for IBC
commercial HMO, POS, and PPO and Medicare Advantage HMO and PPO members, you
must submit the claim directly to IBC. This requirement applies both to
providers in the IBC five-county service area (i.e., Bucks, Chester, Delaware,
Montgomery, and Philadelphia) and providers located in contiguous counties
(i.e., counties that surround the IBC five-county service area).
Claims for IBC members may not be submitted to a local plan if the provider is
contracted with IBC. For example, an IBC-participating provider located in
Camden County, New Jersey (i.e., a contiguous county) should not submit a claim
to Horizon Blue Cross Blue Shield of New Jersey for an IBC member. Rather, he
or she should submit the claim directly to IBC.
If an IBC-participating provider attempts to submit a claim to their local plan
for an IBC member, the claim will be denied. No payment will be issued by IBC
until the claim is correctly submitted to IBC.
If you have any questions about this requirement, please contact your Network
Coordinator.