EOB And Remittance Guide 2700 Ibc
User Manual: EOB 2700
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EOB and Remittance Guide EOB and Remittance Guide January 2014 Independence Blue Cross offers products directly, through its subsidiaries Keystone Health Plan East and QCC Insurance 1 ofof3the Blue Cross and Blue Shield Association. Company, and with Highmark Blue Shield — independentPage licensees EOB and Remittance Guide IBC is in the process of migrating members to a new operating platform. As such, functionality on the NaviNet® web portal will vary based on the migration status of our members. For more information about our business transformation, go to www.ibx.com/pnc/businesstransformation. The EOB (Explanation of Benefits) and Remittance transaction allows you to view, download, and print copies of weekly EOB and Remittance reports in PDF format for migrated members. You will need Adobe Reader on your computer to open these documents. Note: To produce a report for a non-migrated member, use the Online SOR Inquiry transaction. Important notes This transaction produces reports for finalized claims processed only on the new platform. Providers currently enrolled for the Online Statement of Remittance (SOR) can access their remittance data for claims processed on the current IBC platform (i.e., for members not yet migrated to the new platform). To produce a report for the non-migrated members, use the Online SOR Inquiry transaction. Accessing your EOB and Remittance information 1. Select ePayment from the Plan Transactions menu, and then EOB and Remittance. 2. In the EOB and Remittance Search screen, select the billing provider and date range and then select Search. Please note the following: Click in the Billing Provider field to display a list of provider groups/facilities. To narrow the results, enter part of the provider name, NPI, or provider ID. The system will display matching entries as you type. The date range defaults to the most recent two weeks; however, you can edit the dates as needed. Date ranges can go back as far as 121 days in two-week increments. The date range you specify retrieves all EOBs and Remittances created in that period for IBC migrated members. Your results display a statement date that represents the date your funds are made available. To produce a report for the non-migrated members, use the Online SOR Inquiry transaction. Page 2 of 3 EOB and Remittance Guide 3. In the Search Results screen, identify the EOB or Remittance and select Download PDF to view or download the statement. 4. To modify the search criteria, select Modify Search. 5. When you select Download PDF, you are prompted to either open or save the PDF. It is recommended that you save this file. Please note the following: If you choose Open, the document opens using Adobe Reader. If you choose Save, you can keep or rename the default file name (e.g., file name: EOB_Remittance_20131201ProviderID00000043.pdf). Tips This transaction retrieves EOBs and Remittances for IBC only and includes only migrated members. To produce a report for the non-migrated members, use the Online SOR Inquiry transaction. To maximize efficiency, download all EOBs and Remittances for distribution and ongoing use. The Payment Type column indicates whether the statement is for an Explanation of Benefits (professional providers) or a Remittance (facility providers only). The Check Number column for Professional offices will have one check number per remittance. It is common for a Facility Remittance to contain multiple payments. For these instances, the Check Amount column will display a sum of all checks, and the Check Number column will be blank. ® NaviNet is a registered trademark of NaviNet, Inc., an independent company. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Page 3 of 3
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