Reminder: Verify member eligibility on each office visit

As a reminder, Anthem Blue Cross and Blue Shield (Anthem) strongly encourages providers to verify member eligibility on each visit, in addition to obtaining a copy of the ID card. The most current member ID cards no longer show specific cost sharing information, such as copays or coinsurance. Therefore, it is imperative that eligibility is verified, along with the confirmation of cost sharing.

 

Verification of eligibility and cost sharing can be completed in a few different ways:

 

• The Availity portal’s eligibility and benefits feature can provide the coverage effective dates during a benefit period.
  
  
• Providers can also call customer service number on the member’s ID card to speak with an Anthem representative.

 

Members must present a current ID card at the time of service. Providers should request the ID card as there may be changes from one benefit period to the next. If the member ID number changes and the services rendered span benefit periods, providers may need to split the services by member ID to avoid claim rejections. 

 

Anthem routinely recommends that members learn more about benefits through our digital and online tools. Members have the ability to view, download, email and fax electronic version of ID cards using the Anthem Anywhere mobile app.

 

Member ID Prefixes

 

The Blue Cross Blue Shield Association (BCBSA) assigns member ID prefixes for all Blue Cross and Blue Shield branded plans, Anthem plans, as well as non-Anthem plans. Anthem now assigns prefixes that contain a combination of letters and numbers, or alpha-numeric prefixes.

 

*Please take the following actions immediately to avoid possible business disruption:

• Check your EDI software to ensure readiness to accept alpha-numeric prefixes.
• Obtain the most recent member ID card.
• When submitting claims, enter the identification number exactly as it appears on the member’s ID card.
• Review any internal documents and update any references to “alpha prefix” to “prefix.”

 

Anthem will continue to focus and expand our consumer tools and content to assist members in making more informed and personalized health care decisions.