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Check member ID card and verify eligibility with every visit

July 26, 2019

Independence patients may be issued new member ID cards throughout the year, based on renewal dates or plan changes. It is important that providers confirm the member’s coverage and eligibility at each visit, prior to rendering services.

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® Open web portal (NaviNet Open) 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 Questionnaire: 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 through ibx.com.
  • You may access real time, detailed eligibility and benefits information for Independence members through NaviNet Open 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 Open and ibx.com are available seven days a week.

 

NaviNet® is a registered trademark of NantHealth, an independent company.


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