As previously communicated, IBC is in the process of transitioning to a new
claims processing platform, which will offer greater capabilities, increased
flexibility in benefit design, and enhanced functionalities for an improved
overall customer experience.
During this transition, we will be working with you in a dual claims-processing
environment until all of our membership is migrated to the new platform. In
other words, as members are migrated, their claims will be processed on the new
platform; we will continue to process claims on the current IBC platform for
members who have not yet been migrated.
One area of change during the transition is to the Statement of Remittance
(SOR):
For non-migrated members. Until a member is migrated, providers will continue
to receive the same SOR that they currently receive today.
For migrated members. For members who have been migrated to the new platform,
providers will no longer receive the current SOR. Professional providers will
receive what will be called the Explanation of Benefits, and facility providers
will receive what will be called the Provider Remittance.
In early October, detailed guides for the new Explanation of Benefits and
Provider Remittance will be available on the Provider News Center in the
Business Transformation section. Terms in the new documents are explained to
assist you in interpreting your payments.
We anticipate that claims processing for all IBC membership will be
transitioned to the new platform by mid-2015. At that time, you will only
receive the new Explanation of Benefits or Provider Remittance.
For more information, please visit our
Business
Transformation web page. On this site, you will find a communication
archive and Frequently Asked Questions (FAQ) document. If you still have
questions after reviewing the FAQ, email us at
provider_communications@ibx.com.