Check member ID cards and verify eligibility

February 1, 2021

​Some Independence patients received a new member ID card for coverage effective in 2021.

Please confirm the member's coverage and eligibility at each visit and before rendering services.

Medical Policy/PreCertification for out-of-area Blue Plan members

The Medical Policy/Precertification Router allows an Independence network provider access to information about the out-of-area Blue members Home Plan through NaviNet Open.* For more detailed information about NaviNet Open and for access to our NaviNet Open transaction user guides, visit the NaviNet Open section.

Best practices

  1. Make a copy of their ID card. Use the most recent member information when submitting claims.

    For out-of-area Blue Plan members, refer to the Quick guide to Blue member ID cards.

  2. Verify eligibility and benefits. Use the Eligibility and Benefits Inquiry transaction on the NaviNet® web portal (NaviNet Open).*

    For out-of-area Blue Plan members, use the BlueExchange® Out of Area transaction.

  3. Complete the COB, as applicable. For out-of-area Blue Plan members, have them complete the Coordination of Benefits (COB) Questionnaire for Out-of-Area Members, if applicable.

If a member does not have their new ID card yet or forgot it, ask the member to print a temporary ID card by logging on to our secure member portal available at ibx.com.

For your convenience, NaviNet Open* and ibx.com are available seven days a week.

*If your organization has transitioned to use PEAR Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal, you can use the Eligibility & Benefits and BlueExchange® Out of Area transactions to view this information. Additional information and self-service training materials are available in the PEAR ​Help Center.

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