Skip Ribbon Commands
Skip to main content
Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Check member ID card and verify eligibility with every visit

February 12, 2019

Some of your Independence patients may have received a new member ID card for coverage effective in 2019. It is important that providers confirm the member's coverage and eligibility at each visit, prior to rendering services.

Medical Policy/PreCertification for out-of-area Blue Plan members

The Medical Policy/Precertification Router allows an Independence network provider access to information about the out-of-area Blue members Home Plan through NaviNet. For more detailed information about NaviNet and for access to our NaviNet transaction user guides, visit the NaviNet Resources section.

For our Independence and out-of-area Blue Plan members, providers should:

  1. Make a copy. Make a copy of the member's current ID card to ensure that the most up-to-date information is submitted on the claim. Refer to the Quick guide to Blue member ID cards for information on the various ID cards that could be presented by out-of-area Blue Plan members.
  2. Verify eligibility and benefits. Verify eligibility and benefits on the NaviNet® web portal through the Eligibility and Benefits Inquiry transaction. For out-of-area Blue Plan members, use the BlueExchange® Out of Area transaction.
  3. Complete COB, as applicable. For out-of-area Blue Plan members, have them complete the Coordination of Benefits (COB) Questionnaire for Out-of-Area Members, if applicable.

There may be occasions when a member's health insurance goes into effect before he or she receives a member ID card in the mail. In these situations, you have options:

  • You may ask members to print a temporary ID card by logging on to our secure member portal, ibxpress.com.
  • You may access real time, detailed eligibility and benefits information for Independence members through NaviNet using the Eligibility and Benefits Inquiry transaction. There you will find information about a member's demographics, insurance, and cost-sharing information (i.e., copayment, deductible, and coinsurance).

For your convenience, NaviNet and ibxpress.com are available seven days a week.

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.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
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.