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.