Effective March 5, 2026, Independence Blue Cross (IBX) will be implementing a new claim payment policy for emergent inpatient admissions up to and including five (5) days for Medicare Advantage members. This claim payment policy is designed to reduce administrative burdens and help hospitals get paid faster by eliminating the need to correct claims from an inpatient bill type to outpatient/observation.
For purposes of payment determination under this policy, the criteria, definitions, and requirements outlined here take precedence over those in the Hospital Manual, including its definition of admission review. The Hospital Manual's definition of admission may still apply for operational or payment processes not governed by this policy. The Hospital Manual will be updated as needed to ensure alignment; however, until those revisions are issued, this payment policy shall supersede the Hospital Manual where conflicts arise.
For more information
Review the following policy notification, which was published on February 3, 2026:
Learn more about this new policy by reviewing our FAQ. If you have questions after reviewing the FAQ, please email eiapolicyinquiries@ibx.com.
Note: The above policy notification link will expire and become unusable on March 5, 2026, when the new policy is issued.
To access the most updated version of any active po licy, please refer to the Medical and Claim Payment Policy Portal or simply navigate to the Commercial or Medicare Advantage policy bulletins.
26-0036