Throughout 2012, IBC announced its plans to transition coreprocessing activities to a new platform managed and operatedby Highmark, Inc. (Highmark), an independent company. Thenew platform will offer greater capabilities, increased flexibilityin benefit design, and enhanced functionalities to improve theoverall customer experience.

In 2013, we made significant progress on this importanttransition, including the following two milestones:

• Transition of X12 transactions. One of the key early stepsin IBC?s Business Transformation was the transition of X12transactions from the former X12 Gateway to the HighmarkGateway. This task was completed before November 1, 2013,and as a result, all trading partners now send and receivetransactions to/from the Highmark Gateway.
• First groups migrated to new platform. Claims processingfor Federal Employee Program (FEP), Host BlueCard^?, and afew small employer groups was migrated to the new platformon November 1, 2013.
  
  Many more group customers have been migrated to thenew platform as of January 1, 2014. As a result, providerswill notice growing numbers of migrated members by way ofnewly issued ID cards.

We will continue to migrate our membership to the new platformin stages, generally based on when the customer/member?scontract renews. We anticipate that claims processing for allIBC membership will be transitioned to the new platform bymid-2015.

Dual claims-processing environment

During the migration, we will be working with you in a dualclaims-processing and business-operating environment untilall of our business is on the new platform. In other words, wewill begin to process a larger portion of claims and businesstransactions on the new platform as members are migrated,and we will continue to process claims and conduct businesstransactions on the current IBC platform for members who havenot yet been migrated. The date of service will determine theplatform on which these claims will be processed.

Here are some of the important changes wecommunicated in 2013 that will affect the way you dobusiness with us:

• Member ID cards/numbers. As members aremigrated to the new platform, they will be issued anew member ID card with a new ID number and,in some cases, a new alpha prefix. The subscriberand all members covered under the subscriber?spolicy will share the same ID number. Due to thesechanges, it is imperative that you obtain a copy of themember?s current ID card at every visit to ensure thatyou submit the most up-to-date information to IBC.
• Provider payment. For claims processed on thenew platform, you will receive a different format ofthe Statement of Remittance (SOR). On the newformat for facility claims, services will be combinedand displayed on one line. You will continue toreceive our current format of the SOR for claimsprocessed on the current IBC platform. In addition,835 transactions generated on the new platform willcontain additional and updated information.
• Claims processing. Additional data elementsare required to ensure proper claims processingon the new platform. For example, taxonomycodes are required on all claims submissions.Information regarding the specific data elementsrequired can be found in the IBC HIPAA TransactionStandard Companion Guide, which is available atwww.highmark.com/edi-ibc.
• Provider Automated System. The ProviderAutomated System is being retired in stages, aspreviously communicated. Once a member has beenmigrated to the new platform, providers will no longerbe able to use the Provider Automated System forthat member for any functionality (e.g., eligibility,claims status, authorizations). Providers must usethe NaviNet^? web portal to retrieve this information.
• NaviNet. Many changes have been implementedon IBC NaviNet Plan Central, including adding,removing, and enhancing transactions. Formore specific details, please refer to the NaviNetTransaction Changes section of our BusinessTransformation site. This section of our sitecontains user guides and webinars for manyupdated transactions.

Resources

We are committed to working closely with you and ourentire provider network as we complete our BusinessTransformation. During this interim state, we willcontinue to provide comprehensive communicationsand tools to support our members and providernetwork, both during and after the transition to thenew platform.

For more information about our BusinessTransformation, please visit our dedicated site atwww.ibx.com/pnc/businesstransformation. On thissite you will find a communication archive as well as aFrequently Asked Questions (FAQ) document. If youstill have questions after reviewing the FAQ, send usan email.

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