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SOR changes for members migrated to the new platform

October 2, 2013

As previously communicated, IBC is in the process of transitioning to a new claims processing platform, which will offer greater capabilities, increased flexibility in benefit design, and enhanced functionalities for an improved overall customer experience. 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 Statement of Remittance (SOR): For non-migrated members. Until a member is migrated, providers will continue to receive the same SOR that they currently receive today. For migrated members. For members who have been migrated to the new platform, providers will no longer receive the current SOR. Professional providers will receive what will be called the Explanation of Benefits, and facility providers will receive what will be called the Provider Remittance. In early October, detailed guides for the new Explanation of Benefits and Provider Remittance will be available on the Provider News Center in the Business Transformation section. Terms in the new documents are explained to assist you in interpreting your payments. We anticipate that claims processing for all IBC membership will be transitioned to the new platform by mid-2015. At that time, you will only receive the new Explanation of Benefits or Provider Remittance. For more information, please visit our Business Transformation web page. 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 at provider_communications@ibx.com.

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