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Independence Blue Cross - Keystone Health Plan East (HMO)

Field

Description

Assignment of Benefits

and

Release of Information

In Patient>General>Payers>HIPAA, the Assign Benefits (Assignment of Benefits) and Rel Infor (Release of Information) fields are currently set to Y by default for each carrier. Change to N where applicable.

Insurance ID

Enter the patient's subscriber ID including alphabetic characters in the Insurance ID field in Patient>General>Payers.

Note: Spaces, dashes and other special characters that may appear on the ID card are not part of the identification code and, therefore, should not be submitted in this transaction.

Federal Tax ID

-OR-

Social Security Number

-AND-

Provider Taxonomy Code

For the patient's attending physician and referring physician, enter either the physician's federal tax ID or Social Security Number.

Enter the physician's taxonomy code.

These fields are located in Resource>General>Roles.

Operators

Enter the resource ID for each operator creating electronic billing files in the ID column in Administration>Configuration>Operators>Basic.

Provider Taxonomy Code

Enter the agency's provider taxonomy code in the Provider Taxonomy Code field in Administration>Financial>Insurance Codes>General.

Provider No.

Enter the organization's IBC-KEYSTONE assigned provider number in the Provider No field in Administration>Financial>Insurance Companies>Company.

Receiver ID (File Recipient): Insurance Codes

Enter NCCP in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Codes>EMC.

Receiver ID (File Recipient): Insurance Companies

Enter the appropriate payer ID codes for each insurance carrier in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Companies>Company.

The appropriate values are the following:

Receiver ID (Payer)

Enter NCCP in the Receiver ID (Payer) field in Administration>Financial>Insurance Codes>EMC.

Receiver Name (Payer)

Enter AmpMed in the Receiver Name (Payer) field in Administration>Financial>Insurance Codes>EMC.

Request for paper EOB

To receive a paper EOB, select the Request Paper EOB check box in Administration>Financial>Insurance Codes>EMC.

Submitter ID

Enter the agency's NaviMedix user ID in the Submitter ID field in Administration>Financial>Insurance Codes>EMC.

Test Submission Indicator

Select the Test Submission Indicator check box in Administration>Financial>Insurance Codes>EMC to indicate if this is a test file being sent.

Field

Description

Assignment of Benefits

and

Release of Information

In Patient>General>Payers>HIPAA, the Assign Benefits (Assignment of Benefits) and Rel Infor (Release of Information) fields are currently set to Y by default for each carrier. Change to N where applicable.

Insurance ID

Enter the patient's subscriber ID (including alphabetic characters) in the Insurance ID field in Patient>General>Payers.

Note: Spaces, dashes, and other special characters that may appear on the ID card are not part of the identification code and should not be submitted in this transaction.

Federal Tax ID

-OR-

Social Security Number

-AND-

Provider Taxonomy Code

For the patient's attending physician and referring physician, enter either the physician's federal tax ID or Social Security Number.

Enter the physician's taxonomy code.

These fields are located in Resource>General>Roles.

Operators

Enter the resource ID for each operator creating electronic billing files in the ID column in Administration>Configuration>Operators>Basic.

Provider Taxonomy Code

Enter the agency's provider taxonomy code in the Provider Taxonomy Code field in Administration>Financial>Insurance Codes>General.

Provider No.

Enter the organization's IBC-KEYSTONE assigned provider number in the Provider No field in Administration>Financial>Insurance Companies>Company.

Receiver ID (File Recipient): Insurance Codes

Enter NCCP in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Codes>EMC.

Receiver ID (File Recipient): Insurance Companies

Enter the appropriate payer ID codes for each insurance carrier in the Receiver ID (File Recipient) field in Administration>Financial>Insurance Companies>Company.

The appropriate values are the following:

Receiver ID (Payer)

Enter NCCP in the Receiver ID (Payer) field in Administration>Financial>Insurance Codes>EMC.

Receiver Name (Payer)

Enter AmpMed in the Receiver Name (Payer) field in Administration>Financial>Insurance Codes>EMC.

Request for paper EOB

To receive a paper EOB, select the Request Paper EOB check box in Administration>Financial>Insurance Codes>EMC.

Submitter ID

Enter the agency's NaviMedix user ID in the Submitter ID field in Administration>Financial>Insurance Codes>EMC.

Test Submission Indicator

Select the Test Submission Indicator check box in Administration>Financial>Insurance Codes>EMC to indicate if this is a test file being sent.