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On January 1, 2015, all Medicare Advantage HMO and PPO members will
be migrated to the new operating platform. Therefore, if you render services to
these members on or after January 1, 2015, the claim will be processed on the
new platform.
Medicare Advantage HMO and PPO members received a letter from Independence
that highlighted the changes they would experience post-migration, including
new ID cards and a new, easier-to-read billing statement.
Check member ID cards at every visit
All Medicare Advantage HMO and PPO members have been issued a new member ID
card, which includes a new alpha prefix and new member ID and pharmacy ID
numbers. New member ID numbers contain 12 digits, called a "unique member ID"
(UMI). The subscriber and any members covered under the subscriber's policy, if
applicable, share the same UMI.
Because all Medicare Advantage HMO and PPO members have a new member ID
number, it is imperative that provider offices do the following at every visit:
- Obtain a copy of the member's current ID card to ensure that you submit the
most up-to-date information to Independence.
- Verify eligibility and benefits using the NaviNet® web
portal prior to rendering service.
Note: Members with MedigapSecurity (a Medicare Supplement plan) have
been assigned a 13-digit ID number, with the last digit being an alpha
character.
Update on the migration of commercial members to the new
platform
Since 2013, we have been in the process of migrating our commercial members
to the new platform, generally based on when the customer/member's contract
renews. As of January 1, 2015, nearly all of our existing commercial members
will have been migrated to the new platform. We anticipate that all remaining
members will be migrated to the new platform by March 2015.
Resources
We will continue to work closely with you and our entire provider network as
we complete our Business Transformation. For more information, visit our Business Transformation
site. On this site you will find a communication archive as well as
frequently asked questions. If you still have questions after reviewing these
resources, please email
us.
Reminders:
- Once a member has been migrated to the new platform, the Provider Automated
System is no longer available for eligibility inquiries, submitting or
retrieving referrals, submitting encounters, or checking claims status.
Providers should use NaviNet to retrieve this information.
- For members who have been migrated to the new platform, providers will no
longer receive a Statement of Remittance (SOR). Professional providers will
receive a Provider Explanation of Benefits (EOB), and facility providers will
receive a Provider Remittance.
NaviNet® is a registered trademark of
NaviNet, Inc., an independent company.
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