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As previously communicated, IBC is transitioning to a new claims processing
platform that will offer enhanced
functionalities. 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 display of the
reimbursement for multiple outpatient surgeries for
Indemnity/Traditional, Federal Employee Program (FEP), and Host
BlueCard® claims. Please note the following:
- Claims processed on the current IBC platform.
Reimbursement for multiple outpatient surgical procedures will
continue to be rolled up and displayed on one payment line, as shown
below.
Claim ID
Claim line
Rev code
Procedure code
Contracted rate
Reimbursement
1234
1
0360
23130
$100 x 2.5 = $250
$375.00
1234
2
0369
23156
$50 x 2.5 = $125
$0.00
- Claims processed on the new platform. Reimbursement
for multiple outpatient surgical procedures will be
displayed on two or more separate payment lines, as shown
below.
Claim ID
Claim line
Rev code
Procedure code
Contracted rate
Reimbursement
1234
1
0360
23130
$100 x 2.5 = $250
$250.00
1234
2
0369
23156
$50 x 2.5 = $125
$125.00
As a reminder, as of November 1, 2013, FEP and Host BlueCard claims are
processing on the new platform.
Indemnity/Traditional claims will continue to be processed on the current IBC
platform until this membership is
migrated to the new platform.
For more information about our Business Transformation, please visit our dedicated
site. 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.
Navinet® is a registered trademark of
Navinet, Inc., an independent company.
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