[
As previously communicated, 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.
Note: Use our payer ID grids to find the appropriate claims
submission information based on the IBC member's health plan. The payer ID
grids are available in the EDI section of
our website.
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.
]