This article was updated to clarify the instructions to confirm member eligibility.
Independence is pleased to announce a new joint venture with Anthem, Inc., under the name of Blue Medicare Advantage (Blue MA). Blue MA is the trade name of Group Retiree Health Solutions, Inc., an independent licensee of the Blue Cross Blue Shield Association. Through this partnership, Blue MA will offer a new group retiree Medicare Advantage PPO plan, available January 1, 2021. Plan members are covered under the BCBS Medicare Advantage PPO network sharing program.
This means that all Blue MA members can get in-network benefits when outside their service area if they see a contracted MA PPO provider.
Providing care to Blue MA members
Providers can recognize Blue MA members by the logo on their ID card. Members will show their Blue Cross® and/or Blue Shield® member ID rather than their Medicare ID card at office visits.
If you are a contracted MA PPO provider, you should provide the same access to care as you do for your Independence MA PPO patients. You will receive the same contracted rates for services.
If you are not a contracted MA PPO provider, you are not required to see Blue MA members. The services you provide will be reimbursed at the Medicare allowed amount based on the member's out-of-network benefits and where the services were rendered. Reimbursement rates can be found at
www.cms.gov.
You may not balance bill Medicare Advantage members for any difference in charges and the allowance. If you have a question about the reimbursement amount you received, call us at
1-800-ASK-BLUE (1-800-275-2583).
Operational procedures
The
Blue MA manual contains information about the plan and its operational policies and procedures. You can find it on the Blue MA
website.
Verifying eligibility
You can verify member eligibility and cost-sharing (i.e., copayment, deductible, and coinsurance) information on the NaviNet® web portal (NaviNet Open). Select the BlueExchange® Out of Area workflow and use the Benefits and Eligibility Inquiry transaction. You can also call 1-800-676-BLUE (1-800-676-2583). You will be asked to provide the member's prefix on the ID card.
Submitting claims
You can submit claims to Independence using your standard billing practices. You should not bill Medicare directly for services rendered to any Medicare Advantage member.
Learn more
To learn more about Blue MA, click
here.
Our representatives are available to help providers at
1-800-ASK-BLUE (1-800-275-2583).
Blue Medicare Advantage is the trade name of Group Retiree Health Solutions, Inc. an independent licensee of the Blue Cross and Blue Shield Association.