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Update on our Business Transformation

October 1, 2014

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In November 2013, Independence began transitioning its members to a new claims processing platform. The new platform offers greater capabilities, increased flexibility in benefit design, and enhanced functionalities to improve the overall customer experience.

We have made significant progress on this important transition, including the following milestones:

  • Transition of X12 transactions. As of November 1, 2013, all trading partners send and receive transactions to/from the Highmark Gateway.
  • FEP and Host claims. Claims processing for Federal Employee Program (FEP) and Host BlueCard® was migrated to the new platform on November 1, 2013.
  • Commercial member claims. Since November 2013, we have been migrating our commercial members to the new platform, generally based on when the customer/member's contract renews. As of October 1, 2014, approximately half of our existing commercial members have been migrated to the new platform.
Independence will migrate all Medicare Advantage HMO and PPO members to the new platform on January 1, 2015.

We anticipate that all members will be migrated to the new platform by March 2015.

Dual claims-processing environment

During the migration, we are working with you in a dual claims-processing environment until all of our business is on the new platform. In other words, we are processing a larger portion of claims and business transactions on the new platform as members are migrated, and we continue to process claims and conduct business transactions on the current platform for members who have not yet been migrated.* The date of service will determine the platform on which these claims will be processed.

Check member ID cards at every visit

As members are migrated to the new platform, they are issued a new member ID card. For this reason, it is imperative that provider offices do the following:

  1. Obtain a copy of the member's current ID card at every visit to ensure that you submit the most up-to-date information to Independence.
  2. Verify eligibility and benefits using the NaviNet® web portal prior to rendering service.
Independence will assign migrated members a new 12-digit member ID number, called a "unique member ID" (UMI). Each member ID card will include the member's name and the subscriber's UMI. The subscriber and all members covered under the subscriber's policy will share the same ID number. Some plans will also be assigned a new three-character alpha prefix, which will also appear as part of the ID number.

Note: Members with MedigapSecurity (a Medicare Supplement plan) will be assigned a 13-digit ID number, with the last digit being an alpha character.

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 dedicated 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, email us.

*Behavioral health claims for HMO/POS non-migrated members should continue to be submitted to Magellan Behavioral Health, Inc. Behavioral health claims for all migrated members, including HMO/POS, should be submitted to Independence.

Magellan Behavioral Health, Inc., an independent company, manages mental health and substance abuse benefits for most Independence members.

NaviNet® is a registered trademark of NaviNet, Inc., an independent company.


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.
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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.