Medicare Supplement System Consolidation FAQs
Anthem Blue Cross and Blue Shield will consolidate Individual (non-group) Medicare Supplement members to a
single claims processing system Dec. 1, 2016.
Group-sponsored Medicare Supplement plan members are not affected by these changes.
Questions and Answers
What prefixes will be used for individual Medicare Supplement members beginning Dec. 1, 2016?
Some prefixes will change. Please see chart below.
State Current Prefix New Prefix Effective Dec. 1, 2016
OH
YRR
VNE
IN
YRR
VNF
KY
YRR
VNG
MO
JWE
VNH
Alpha prefixes for CO (XFG and XFO), NV (YFG AND YFZ) and WI (VZQ, VZL, AUQ AND VZA) will not change as a
result of this transition.
Will the member’s Health Care ID (HCID) or member ID remain the same?
In most cases the HCID, commonly known as the member ID, did not change due to migration. Plan members that
are dependents under one policy will also receive a new HCID number effective Dec. 1, 2016. Please review the
member’s identification card for any changes.
Will group numbers be changing?
Yes. All of the individual medical group numbers for the Medicare Supplement business will change. Changes will
be effective Dec. 1, 2016.
Are members in Medicare Supplement Employer Sponsored plans part of this change?
No. Members in Medicare Supplement Employer Sponsored plans are not part of this change. This FAQ is regarding
new ID cards and group number changes for individual Medicare Supplement members.
Will receipt of provider payments and remittances change?
Yes. Payments will be processed daily. Remittances that may have been sent out only once a week will be received
more frequently.
Are prior authorizations required for Medicare Supplement members?
This product requires primary coverage with Medicare, therefore authorizations with Anthem are not needed with the
exception of prescription drugs for a few policies.
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Will prior authorization for outpatient prescriptions obtained prior to this change continue to be recognized
after the system transition?
Yes. Any prior authorizations for outpatient prescription drugs obtained prior to the system changes do not require a
new authorization. For plans with outpatient prescription drug coverage please contact provider services to verify
benefits. The fax number for outpatient prescription drug authorizations when covered by our policies is: 1-866-3103666.
What remains the same after the Medicare Supplement claims system migration?
• Claims will continue to crossover from Medicare automatically for Medicare Supplement to process.
Please check remittances for message claim has crossed over. When a Medicare claim has crossed
over to Anthem for secondary payment, providers should wait 30 calendar days from the Medicare
remittance date before submitting another claim to Anthem. Providers can identify if a claim has been
crossed over for secondary payment by the following Medicare Remittance Advice remarks. Medicare
remittance advice remark codes MA18 or N89 indicate that Medicare crossover has been forwarded
to the secondary carrier:
• MA18 Alert: The claim information is also being forwarded to the patient's supplemental insurer.
Send any questions regarding supplemental benefits to them.
• N89 Alert: Payment information for this claim has been forwarded to more than one other payer,
but format limitations permit only one of the secondary payers to be identified in this remittance
advice.
• Continue to reach provider customer service by calling the number on the back of the
member’s ID card. Please note, however, that Interactive Voice Response (IVR) options have
changed.
• Continue to use Availity: Availity can be accessed in the same manner as before and will
continue to have information about individual Medicare Supplement. Please ensure the new 2016
alpha prefixes are used for individual Medicare Supplement members as outlined above with their
respective effective dates.
• Continue to use the same mailing address, Electronic Data Interchange gateway as you do
today: Claims and correspondence should continue to be submitted to same EDI gateway and the
same Post Office Box address.
What if I use a claims clearing house to file Medicare Supplement claims?
If you use a claims clearing house to file Medicare Supplement claims, please ensure the clearing house waits 30
calendar days from the Medicare remittance date before submitting another claim to Anthem.
If you have any questions regarding this information, please contact Anthem Provider Services at the
following phone numbers:
State
CO (no change)
NV (no change)
WI (no change)
OH
IN
KY
MO
Through Nov. 30, 2016
844-660-0434
866-438-9969
866-341-1053
800-282-1016
800-345-4344
888-650-4133
800-490-6217
Dec. 1, 2016 and thereafter
844-660-0434
866-438-9969
866-341-1053
866-649-2037
866-649-2033
866-848-1057
888-596-0273
59396MUPENMUB 03/22/2016
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and
Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In
Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri
(excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life
Insurance Company (HALIC). RIT and certain affiliates administer benefits underwritten by HALIC. RIT and certain
affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In New Hampshire:
Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. Anthem Health Plans of
Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for
the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Benefits underwritten by
Blue Cross Blue Shield of Wisconsin. Independent licensees of the Blue Cross and Blue Shield Association.
ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names
and symbols are registered marks of the Blue Cross and Blue Shield Association.
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